Methods to establish and restore normal gut microbiota function of subject in need thereof

ABSTRACT

The present invention provides a method to define normal maturation of the gut microbiota using a limited number of bacterial taxa found in the gut microbiota. Regressing the relative abundance of age-discriminatory taxa in their gut microbiota against the chronological age of each healthy subject at the time a sample of the gut microbiota was collected produces a regression model that may be used to characterize the maturity of another subject&#39;s gut microbiota to provide a measure of gastrointestinal health without having to query the whole microbiota. The present invention also provides composition and methods for preventing and/or treating a disease in a subject in need thereof.

CROSS REFERENCE TO RELATED APPLICATIONS

This application claims the priority of PCT application No. PCT/US2014/063711, filed Nov. 3, 2014, which claims priority to U.S. provisional application No. 61/898,938, filed Nov. 1, 2013, each of which is hereby incorporated by reference in its entirety.

FIELD OF THE INVENTION

The present invention provides a method to define normal maturation of the gut microbiota using a limited number of bacterial taxa found in the gut microbiota. Regressing the relative abundance of age-discriminatory taxa in their gut microbiota against the chronological age of each healthy subject at the time a sample of the gut microbiota was collected produces a regression model that may be used to characterize the maturity of another subject's gut microbiota to provide a measure of gastrointestinal health without having to query the whole microbiota. The present invention also provides composition and methods for preventing and/or treating a disease in a subject in need thereof.

REFERENCE TO SEQUENCE LISTING

A paper copy of the sequence listing and a computer readable form of the same sequence listing are appended below and herein incorporated by reference. The information recorded in computer readable form is identical to the written sequence listing, according to 37 C.F.R. 1.821(f).

BACKGROUND OF THE INVENTION

Systematic analyses of the gut microbiota in different healthy and unhealthy populations have been undertaken in the scientific community for many years. The gut microbiota comprises a complex community whose composition is in flux in infants and is generally stable in adults. Disease, illness, and diet, among other factors, have been shown to affect the proportional representation of the bacterial species comprising the gut microbiota. Accordingly, the gut microbiota is viewed as both a diagnostic and therapeutic target. There remains a need in the art, therefore, for methods to define microbiota maturity using bacterial taxonomic biomarkers that are highly discriminatory for age as a way to characterize the health status of the gut microbiota.

SUMMARY OF THE INVENTION

In an aspect, the present disclosure encompasses a method to determine the maturity of a subject's gut microbiota, the method comprising (a) calculating a relative abundance for each bacterial taxon in a group, from a fecal sample obtained from the subject, wherein the group comprises at least the bacterial taxa listed in rows 1 to 6 of Table A; (b) applying the relative abundances of the bacterial taxa from step (a) to a regression model to determine a microbiota age for the subject's gut microbiota, wherein the model regresses, for a group of healthy subjects, relative abundances of the same bacterial taxa, as determined from a plurality of gut microbiota samples obtained over time for each healthy subject in the group, against the chronological age of each healthy subject in the group at the time the gut microbiota sample was obtained; and (c) calculating the maturity of the subject's gut microbiota, wherein the calculation for maturity is defined as relative maturity, and relative maturity=(microbiota age of the subject)−(microbiota age of a healthy subject of a similar chronological age. In certain embodiments, the group comprises at least the bacterial taxa listed in rows 1 to 6 of Table A and at least one bacterial taxon listed in rows 7 to 24 of Table A.

In another aspect, the present disclosure encompasses a method to determine the maturity of a subject's gut microbiota, the method comprising (a) calculating a relative abundance for each bacterial taxon in a group, from a fecal sample obtained from the subject, wherein the group comprises at least 24 bacterial taxa listed in Table A; (b) applying the relative abundances of the bacterial taxa from step (a) to a regression model to determine a microbiota age for the subject's gut microbiota, wherein the model regresses, for a group of healthy subjects, relative abundances of the same bacterial taxa, as determined from a plurality of gut microbiota samples obtained over time for each healthy subject in the group, against the chronological age of each healthy subject in the group at the time the gut microbiota sample was obtained; and (c) calculating the maturity of the subject's gut microbiota, wherein the calculation for maturity is defined as relative maturity, and relative maturity=(microbiota age of the subject)−(microbiota age of a healthy subject of a similar chronological age. In certain embodiments, the group comprises the bacterial taxa listed in Table B.

In another aspect, the present disclosure encompasses a method to classify a subject, the method comprising (a) calculating a relative abundance for each bacterial taxon in a group, from a fecal sample obtained from the subject, wherein the group comprises at least the bacterial taxa listed in rows 1 to 6 of Table A; (b) applying the relative abundances of the bacterial taxa from step (a) to a regression model to determine a microbiota age for the subject's gut microbiota, wherein the model regresses, for a group of healthy subjects, relative abundances of the same bacterial taxa, as determined from a plurality of gut microbiota samples obtained over time for each healthy subject in the group, against the chronological age of each healthy subject in the group at the time the gut microbiota sample was obtained; and (c) classifying the subject as having normal gut maturation when the microbiota age of the subject is substantially similar to the microbiota age of a healthy subject with a similar chronological age. In certain embodiments, the group comprises at least the bacterial taxa listed in rows 1 to 6 of Table A and at least one bacterial taxon listed in rows 7 to 24 of Table A.

In another aspect, the present disclosure encompasses a method to classify a subject, the method comprising (a) calculating a relative abundance for each bacterial taxon in a group, from a fecal sample obtained from the subject, wherein the group comprises at least 24 bacterial taxa listed in Table A; (b) applying the relative abundances of the bacterial taxa from step (a) to a regression model to determine a microbiota age for the subject's gut microbiota, wherein the model regresses, for a group of healthy subjects, relative abundances of the same bacterial taxa, as determined from a plurality of gut microbiota samples obtained over time for each healthy subject in the group, against the chronological age of each healthy subject in the group at the time the gut microbiota sample was obtained; and (c) classifying the subject as having normal gut maturation when the microbiota age of the subject is substantially similar to the microbiota age of a healthy subject with a similar chronological age. In certain embodiments, the group comprises the bacterial taxa listed in Table B.

In another aspect, the present disclosure encompasses a method to classify a subject, the method comprising calculating a relative abundance for each bacterial taxon in a group, from a fecal sample obtained from the subject, wherein the group comprises at least the bacterial taxa listed in rows 1 to 6 of Table A; applying the relative abundances of the bacterial taxa from step (a) and chronological age of the subject to a classification model, wherein the classification model is trained on datasets comprising measurements obtained from a plurality of healthy subjects and a plurality of undernourished subjects, and the measurements including (i) relative abundances of the same bacterial taxa in step (a), as determined from a plurality of gut microbiota samples obtained over time for each healthy and undernourished subject, and (ii) chronological age of the subject at the time the gut microbiota sample was obtained; and wherein the classification model assigns the subject to a category. In certain embodiments, the group comprises at least the bacterial taxa listed in rows 1 to 6 of Table A and at least one bacterial taxon listed in rows 7 to 24 of Table A.

In another aspect, the present disclosure encompasses a method to classify a subject, the method comprising calculating a relative abundance for each bacterial taxon in a group, from a fecal sample obtained from the subject, wherein the group comprises at least 24 bacterial taxa listed in Table A; applying the relative abundances of the bacterial taxa from step (a) and chronological age of the subject to a classification model, wherein the classification model is trained on datasets comprising measurements obtained from a plurality of healthy subjects and a plurality of undernourished subjects, and the measurements including (i) relative abundances of the same bacterial taxa in step (a), as determined from a plurality of gut microbiota samples obtained over time for each healthy and undernourished subject, and (ii) chronological age of the subject at the time the gut microbiota sample was obtained; and wherein the classification model assigns the subject to a category. In certain embodiments, the group comprises the bacterial taxa listed in Table B.

In another aspect, the present disclosure encompasses a method for identifying an effect of a therapy, the method comprising (a) calculating a relative abundance for each bacterial taxon in a group, from a fecal sample obtained from the subject before and after administration of the therapy, wherein the group comprises at least the bacterial taxa listed in rows 1 to 6 of Table A; (b) applying the relative abundances of the bacterial taxa from step (a) to a regression model to determine a microbiota age for the subject's gut microbiota before and after therapy, wherein the model regresses, for a group of healthy subjects, relative abundances of the same bacterial taxa, as determined from a plurality of gut microbiota samples obtained over time for each healthy subject in the group, against the chronological age of each healthy subject in the group at the time the gut microbiota sample was collected; wherein the therapy has an effect when the microbiota age of the subject changes after therapy. In certain embodiments, the group comprises at least the bacterial taxa listed in rows 1 to 6 of Table A and at least one bacterial taxon listed in rows 7 to 24 of Table A.

In another aspect, the present disclosure encompasses a method for identifying an effect of a therapy, the method comprising (a) calculating a relative abundance for each bacterial taxon in a group, from a fecal sample obtained from the subject before and after administration of the therapy, wherein the group comprises at least 24 bacterial taxa listed in Table A; (b) applying the relative abundances of the bacterial taxa from step (a) to a regression model to determine a microbiota age for the subject's gut microbiota before and after therapy, wherein the model regresses, for a group of healthy subjects, relative abundances of the same bacterial taxa, as determined from a plurality of gut microbiota samples obtained over time for each healthy subject in the group, against the chronological age of each healthy subject in the group at the time the gut microbiota sample was collected; wherein the therapy has an effect when the microbiota age of the subject changes after therapy. In certain embodiments, the group comprises the bacterial taxa listed in Table B.

In another aspect, the present disclosure encompasses method for identifying an effect of a therapy, the method comprising (a) identifying a set of age-discriminatory bacterial taxa within the bacterial taxa comprising the gut microbiota a group of healthy subject's gut microbiota, the method comprising (i) providing, for each healthy subject, a relative abundance for the bacterial taxa comprising the subject's gut microbiota, wherein the relative abundance of the bacterial taxa in the healthy subject's gut microbiota was determined from a plurality of gut microbiota samples obtained at intervals of time; (ii) regressing the relative abundances of the bacterial taxa comprising each healthy subject's gut microbiota against the chronological age of the healthy subject at the time the gut microbiota sample was collected, thereby producing a prediction of a gut microbiota age that is based only on the relative abundance of age-discriminatory bacterial taxa present in the subject's gut microbiota; and (iii) selecting the minimum number of bacterial taxa from step (ii) that is needed to produce a prediction that is substantially similar to or better than the prediction of step (ii); calculating a relative abundance for each bacterial taxon in the set of age-discriminatory taxa from step (a)(iii), using a fecal sample obtained from a subject before and after administration of the therapy; and applying the relative abundances from step (b) to the prediction of gut microbiota age from step (a)(iii) to determine the microbiota age of the subject's gut microbiota before and after therapy; wherein the therapy has an effect when the microbiota age of the subject changes after therapy.

In another aspect, the present disclosure encompasses a composition comprising at least one of the bacterial taxa listed in Table A. The present disclosure also contemplates a method of preventing or treating acute malnutrition, acute diarrhea, or chronic diarrhea in a subject in need thereof, the method comprising administering to the subject a composition comprising at least one of the bacterial taxa listed in Table A.

In another aspect, the present disclosure encompasses a composition comprising a combination of bacterial taxa, the combination comprising of at least two bacterial taxa listed in Table B. The present disclosure also contemplates a method of preventing or treating acute malnutrition, acute diarrhea, or chronic diarrhea in a subject in need thereof, the method comprising administering to the subject a composition comprising a combination of bacterial taxa, wherein the combination comprises at least two bacterial taxa listed in Table B.

In another aspect, the present disclosure encompasses a composition comprising a combination of bacterial taxa listed, wherein the combination is selected from combinations listed in Table D. The present disclosure also contemplates a method of preventing or treating acute malnutrition, acute diarrhea, or chronic diarrhea in a subject in need thereof, the method comprising administering to the subject a composition comprising a combination of bacterial taxa, wherein the combination is selected from combinations listed in Table D.

Other aspects and iterations of the invention are described more thoroughly below.

REFERENCE TO COLOR FIGURES

The application file contains at least one photograph executed in color. Copies of this patent application publication with color photographs will be provided by the Office upon request and payment of the necessary fee.

FIG. 1 depicts graphs and a heat map showing bacterial taxonomic biomarkers for defining gut-microbiota maturation in healthy Bangladeshi children during the first 2 years of life. (A) Twenty-four age-discriminatory bacterial taxa were identified by applying Random Forests regression of their relative abundances in faecal samples against chronologic age in 12 healthy children (n=272 faecal samples). Shown are 97%-identity OTUs with their deepest level of confident taxonomic annotation (also see Table 5), ranked in descending order of their importance to the accuracy of the model. Importance was determined based on the percentage increase in mean-squared error of microbiota age prediction when the relative abundance values of each taxon were randomly permuted (mean importance±s.d., n=100 replicates). (E) The insert shows tenfold cross-validation error as a function of the number of input 97%-identity OTUs used to regress against the chronologic age of children in the training set, in order of variable importance (blue line). (B-D) Microbiota age predictions in a birth cohort of healthy singletons used to train the 24 bacterial taxa model (B, brown, each circle represents an individual faecal sample). The trained model was subsequently applied to two sets of healthy children: 13 singletons set aside for model testing (C, green circles, n=276 faecal samples) and another birth cohort of 25 twins and triplets (D, blue circles, n=448 faecal samples). The curve is a smoothed spline fit between microbiota age and chronologic age in the validation sets (C,D), accounting for the observed sigmoidal relationship (see Methods for Examples 1-9). (F-H) Heatmap of mean relative abundances of the 24 age-predictive bacterial taxa plotted against the chronologic age of healthy singletons used to train the Random Forests model (F), and correspondingly in the healthy singletons (G), and twins and triplets (H) used to validate the model (hierarchical clustering performed using the Spearman rank correlation distance metric).

FIG. 2 depicts graphs and a schematic showing persistent immaturity of the gut microbiota in children with SAM. (A) Design of the randomized interventional trial. (B) Microbiota maturity defined during various phases of treatment and follow-up in children with SAM. Relative microbiota maturity in the upper portion of the panel is based on the difference between calculated microbiota age (Random-Forests-based sparse 24-taxon model) and values calculated in healthy children of similar chronologic age, as interpolated over the first 2 years of life using a spline curve. In the lower portion of the panel, maturity is expressed as a microbiota-for-age Z-score (MAZ). Mean values±s.e.m. are plotted. The significance of differences between microbiota indices at various stages of the clinical trial is indicated relative to healthy controls (arrows above the bars) and versus samples collected at enrollment for each intervention group (arrows below the bars) (post-hoc Dunnett's multiple comparison procedure of linear mixed models; *P<0.05, **P<0.01, ***P<0.001). Healthy children not used to train the Random Forests model served as healthy controls (n=38). (C-F), Plot of microbiota age for each child with SAM at enrollment (C), at the conclusion of the food intervention phase (D), and within (E) and beyond (F) 3 months of follow-up. The curve shown in each panel was fit using predictions in healthy children: this curve is the same as that replicated across each plot in FIG. 1B-D.

FIG. 3 depicts illustrations of the equations used to calculate ‘relative microbiota maturity’ and ‘microbiota-for-age Z-score’. (A,B) The procedure to calculate both microbiota maturation metrics are shown for a single faecal sample from a focal child (pink circle) relative to microbiota age values calculated in healthy reference controls. These reference values are computed in samples collected from children used to validate the Random-Forests-based sparse 24-taxon model and are shown in (A), as a broken line of the interpolated spline fit and in (B), as median±s.d. values for each monthly chronologic age bin from months 1 to 24.

FIG. 4 depicts graphs showing transient microbiota immaturity and reduction in diversity associated with diarrhoea in healthy twins and triplets. (A) The transient effect of diarrhoea in healthy children. Seventeen children from 10 families with healthy twins or triplets had a total of 36 diarrhoeal illnesses where faecal samples were collected. Faecal samples collected in the months immediately before and following diarrhoea in these children were examined in an analysis that included multiple environmental factors in the ‘healthy twins and triplets’ birth cohort. Linear mixed models of these specified environmental factors indicated that ‘diarrhoea’, ‘month following diarrhoea’ and ‘presence of formula in diet’ have significant effects on relative microbiota maturity, while accounting for random effects arising from within-family and within-child dependence in measurements of this maturity metric. The factors ‘postnatal age’, ‘presence or absence of solid foods’, ‘exclusive breastfeeding’, ‘enteropathogen detected by microscopy’, ‘antibiotics’ as well as ‘other periods relative to diarrhoea’ had no significant effect. The numbers of faecal samples (n) are shown in parenthesis. Mean values±s.e.m. are plotted. *P<0.05, ***P<0.001. See Table 6 for the effects of dietary and environmental covariates. (B) Effect of diarrhoea and recovery on age-adjusted Shannon diversity index (SDI). Mean values of effect on SDI±s.e.m. are plotted. *P<0.05, **P<0.01.

FIG. 5 depicts heatmaps and graphs showing gut microbiota variation in families with twins and triplets during the first year of life. (A) Maternal influence. Heatmap of the mean relative abundances of 13 bacterial taxa (97%-identity OTUs) found to be statistically significantly enriched in the first month post-partum in the faecal microbiota of mothers (see column labelled 1) compared to microbiota sampled between the second and twelfth months post-partum (FDR-corrected P<0.05; ANOVA of linear mixed-effects model with random by-mother intercepts). (B) An analogous heatmap of the relative abundance of these taxa in their twin or triplet offspring is shown. Three of these 97%-identity OTUs are members of the top 24 age-discriminatory taxa (blue) and belong to the genus Bifidobacterium. (C-J), comparisons of maternal, paternal and infant microbiota. Mean values±s.e.m. of Hellinger and unweighted UniFrac distances between the faecal microbiota of family members sampled over time were computed. Samples obtained at postnatal months 1, 4, 10 and 12 from twins and triplets, mothers and fathers were analysed (n=12 fathers; 12 mothers; 25 children). (C,D) Intrapersonal variation in the bacterial component of the maternal microbiota is greater between the first and fourth months after childbirth than variation in fathers. (E,F) Distances between the faecal microbiota of spouses (each mother-father pair) compared to distances between all unrelated adults (male-female pairs). The microbial signature of co-habitation is only evident 10 months following childbirth. (G-J) The degree of similarity between mother and infant during the first postpartum month is significantly greater than the similarity between microbiota of fathers and infants (G,H) while the faecal microbiota of co-twins are significantly more similar to one another than to age-matched unrelated children during the first year of life (IA. For all distance analyses, Hellinger and unweighted UniFrac distance matrices were permuted 1,000 times between the groups tested. P values represent the fraction of times permuted differences between tested groups were greater than real differences between groups. *P<0.05, **P<0.01, ***P<0.001.

FIG. 6 graphically depicts anthropometric measures of nutritional status in children with SAM before, during and after both food interventions. (A-C) Weight-for-height Z-scores (WHZ) (A) height-for-age Z-scores (HAZ) (B) and weight-for-age Z-scores (WAZ) (C). Mean values±s.e.m. are plotted and referenced to national average anthropometric values for children surveyed between the ages of 6 and 24 months during the 2011 Bangladeshi Demographic Health Survey (BDHS)²⁸.

FIG. 7 graphically depicts persistent reduction of diversity in the gut microbiota of children with SAM. Age-adjusted Shannon diversity index for faecal microbiota samples collected from healthy children (n=50), and from children with SAM at various phases of the clinical trial (mean values±s.e.m. are plotted). The significance of differences between SDI at various stages of the clinical trial is indicated relative to healthy controls (above the bars) and versus the time of enrollment before treatment (below the bars). *P<0.05, **P<0.01, ***P<0.001 (post-hoc Dunnett's multiple comparison procedure of linear mixed models). See Table 12.

FIG. 8 depicts heatmaps of bacterial taxa significantly altered during the acute phase of treatment and nutritional rehabilitation in the microbiota of children with SAM compared to similar-age healthy children. Bacterial taxa (97%-identity OTUs) significantly altered (FDR-corrected P<0.05) in children with SAM are shown (see Table 13 for P values and effect size for individual taxa). Three groups of bacterial taxa are shown: those enriched before the food intervention (A); those enriched during the follow-up phase compared to healthy controls (B); and those that are initially depleted but return to healthy levels (C). Members of the top 24 age-discriminatory taxa are highlighted in blue. Note that there were no children represented in the Khichuri-Halwa arm under the age of 12 months during the ‘follow-up after 3 months’ period.

FIG. 9 depicts heatmaps of bacterial taxa altered during long term follow-up in the faecal microbiota of children with SAM compared to similar-age healthy children. (A-H) Bacterial taxa (97%-identity OTUs) significantly altered (FDR-corrected P<0.05) in children with SAM are shown (see Table 13 for P values and effect sizes for individual taxa). (A-C) Taxa depleted across all phases of SAM relative to healthy. (D-H) Those depleted during the follow-up phase. Members of the top 24 age-discriminatory taxa are highlighted in blue. Note that there were no children under the age of 12 months represented in the Khichuri-Halwa treatment arm during the ‘follow-up after 3 months’ period.

FIG. 10 graphically depicts the effects of antibiotics on the microbiota of children with SAM. Plots of microbiota and anthropometric parameters in nine children sampled before antibiotics (abx), after oral amoxicillin plus parenteral gentamicin and ampicillin, and at the end of the antibiotic and dietary interventions administered over the course of nutritional rehabilitation in the hospital. All comparisons were made relative to the pre-antibiotic sample using the non-parametric Wilcoxon matched-pairs rank test, in which each child served as his or her own control. (A-C) Microbiota parameters, plotted as mean values±s.e.m., include (A) relative microbiota maturity, (B) microbiota-for-age Z-score (MAZ), and (C) SDI. WHZ scores are provided in D. (E,F) The two predominant bacterial family-level taxa showing significant changes following antibiotic treatment. (E) family Streptococcaceae and (F) family Enterobacteriaceae. ns, not significant; **P<0.01.

FIG. 11 graphically depicts the relative microbiota maturity and MAZ correlate with WHZ in children with MAM. (A-C) WHZ are significantly inversely correlated with relative microbiota maturity (A) and MAZ (B) in a cross-sectional analysis of 33 children at 18 months of age who were above and below the anthropometric threshold for MAM (Spearman's Rho=0.62 and 0.63, respectively; ***P<0.001). In contrast, there is no significant correlation between WHZ and microbiota diversity (C). (D-L), Relative abundances of age-discriminatory 97%-identity OTUs that are inputs to the Random Forests model that are significantly different in the faecal microbiota of children with MAM compared to age-matched 18-month-old healthy controls (Mann-Whitney U-test, P<0.05). Box plots represent the upper and lower quartiles (boxes), the median (middle horizontal line), and measurements that are beyond 1.5 times the interquartile range (whiskers) and above or below the 75th and 25th percentiles, respectively (points) (Tukey's method, PRISM software v6.0d). Taxa are presented in descending order of their importance to the Random Forests model. (D) Faecalibacterium prauznitzii 326792, (E) Dorea longicatena 191687, (F) Lactobacillus mucosae 15141, (G) Catenibacterium mitsuokai 287510, (H) Dorea formicigenerans 261912, (I) Clostridium sp. 181834, (J) Bifidobacterium sp. 469873, (K) Clostridiales sp. 185951, (L) Ruminococcaceae sp. 212619. See FIG. 10A,B.

FIG. 12 depicts graphs and a schematic showing cross-sectional assessment of microbiota maturity at 18 months of age in Bangladeshi children with and without MAM, plus extension of the Bangladeshi-based model of microbiota maturity to Malawi. (A,B) Children with MAM (WHZ lower than −2 s.d.; grey) have significantly lower relative microbiota maturity (A) and MAZ (B) compared to healthy individuals (blue). Mean values±s.e.m. are plotted **P<0.01 (Mann-Whitney U-test). See FIG. 9 for correlations of metrics of microbiota maturation with WHZ and box-plots of age-discriminatory taxa whose relative abundances are significantly different in children with MAM relative to healthy reference controls. (C) Microbiota age predictions resulting from application of the Bangladeshi 24-taxon model to 47 faecal samples (brown circles) obtained from concordant healthy Malawian twins and triplets are plotted versus the chronologic age of the Malawian donor (collection occurred in individuals ranging from 0.4 to 25.1 months old). The results show the Bangladeshi model generalizes to this population, which is also at high risk for malnutrition (each circle represents an individual faecal sample collected during the course of a previous study¹¹). (D) Spearman rho and significance of rank order correlations between the relative abundances of age-discriminatory taxa, and the chronologic age of all healthy Bangladeshi children described in the present study as well as concordant healthy Malawian twins and triplets. *P<0.05.

FIG. 13 graphically depicts that R. obeum restricts V. cholerae colonization in adult gnotobiotic mice. (A,B) V. cholerae levels in the faeces of mice colonized with the indicated human gut bacterial species (n=4-6 mice per group). (A) Days after gavage of second species and (B) Days after V. cholerae gavage. (C) Expression of R. obeum luxS Al-2 synthase in the 14-member community 4 days after introduction of 10⁹ c.f.u. of V. cholerae or no pathogen (n=5 mice per group). Note that D. longicatena levels fall precipitously after V. cholerae invasion (Table 25). Mean values±s.e.m. are shown. ND, not detected. *P<0.05, **P<0.01 (unpaired Mann-Whitney U-test).

FIG. 14 graphically depicts that R. obeum Al-2 reduces V. cholerae colonization and virulence gene expression. (A) R. obeum Al-2 produced in E. coli represses the tcp promoter in V. cholerae (triplicate assays; results representative of four independent experiments). (B) Faecal V. cholerae levels in gnotobiotic mice 8 h after gavage with V. cholerae and an E. coli strain containing either the P_(BAD)-R. obeum luxS plasmid or vector control. (C) Faecal vqmA transcript abundance in mono- or co-colonized mice. (D) Competitive index of ΔvqmA versus wild-type V. cholerae during co-colonization with R. obeum (n=5 animals per group). Mean values±s.e.m. are shown. *P<0.05, **P<0.01, ****P<0.0001 (unpaired two-tailed Student's t-test).

FIG. 15 depicts graphs and illustrations showing the experimental designs for clinical study and gnotobiotic mouse experiments. (A) Sampling schedule for human cholera study. (B) Frequency of diarrhoeal episodes over time for a representative participant (patient A). Initial time (black circle) represents beginning of diarrhoea. The long vertical line marks enrollment into the study. Colours and short vertical lines denote boundaries of study phases defined in (A). (C-H) Depict the various gnotobiotic mouse experimental designs. The number (n) of animals in each treatment group is shown.

FIG. 16 depicts graphs and heatmaps showing the bacterial taxa associated with diarrhoeal and recovery phase. (A) Proportion of bacterial species-level taxa that were observed in both diarrhoeal and recovery phases, in D-Ph1 to D-Ph4 only, and in R-Ph1 to R-Ph3 only. Mean values±s.e.m. are plotted. *P<0.05, ***P<0.001 (unpaired Mann-Whitney U-test). (B-D) Phylum-level analysis. Mean values are plotted. (B) Diarrhea only, (C) Recovery only, and (D) Both phases. (E) Proportion of study participants having bacterial taxa associated by indicator species analysis with the diarrhoeal or recovery phase. The x axis shows species associated with each phase, ranked by proportion of subjects harbouring that species. For each species, ‘representation in study participants’ is the average presence/absence of all 97%-identity OTUs with that species taxonomic assignment. The OTU table was rarefied to 49,000 reads per sample. (F-N) Bacterial species identified by indicator analysis as indicative of diarrhoea or recovery phases in adult patients with cholera, and species identified by Random Forests analysis as discriminatory for different stages in the maturation of the gut microbiota of healthy Bangladeshi infants/children aged 1-24 months (denoted by the symbol †). (F-H) The heat map shows mean relative abundances of species across all individuals during D-Ph1 to D-Ph4, with each phase subdivided into four equal time bins. For recovery time points, columns represent the mean relative abundances for each sampling time point during R-Ph1 to R-Ph3. (I-K) Mean relative abundance values are also presented for these same species in the faecal microbiota of 50 healthy Bangladeshi children sampled from 1 to 2 years of age at monthly intervals. Unsupervised hierarchical clustering used relative abundances of species in the faecal microbiota of the patients with cholera. (F,G,I,J) The green portion of the tree encompasses species that are more abundant during recovery whereas (H,K) the red portion encompasses species that are more abundant during diarrhoea. (L-N) Indicator scores are presented in the right-hand portion of the panel, with ‘score’ for a given taxon defined as its indicator value for recovery minus its indicator value for diarrhoea (−1, highly diarrhoea-associated; +1, highly recovery-associated). Spearman's rank correlation coefficients of mean relative abundances of species by sample in the cholera study versus the mean sample-weighted UniFrac distance to healthy adult faecal microbiota are shown at the extreme right together with the statistical significance of correlations after Benjamini-Hochberg false discovery rate correction for multiple hypothesis testing (NS, not significant; *P<0.05; **P<0.01; ***P<0.001). Higher coefficients indicate increasing divergence from a healthy configuration with higher relative abundance of a given species. Species shown satisfied two or more of the following criteria: (1) presence among the list of the top 40 age-discriminatory species in the Random-Forests-based model of gut microbiota maturation in healthy infants and children; (2) indicator value score greater than 0.7; (3) significant correlation (Spearman'sr) between relative abundance in the faecal microbiota of patients with cholera and UniFrac distance to healthy adult faecal microbiota; and (4) inclusion in the artificial 14-member human gut community (species name highlighted in blue).

FIG. 17 depicts heatmaps showing the 97%-identity OTUs observed in both diarrhoeal and recovery phases. The proportion of 97%-identity OTUs with a given species-level taxonomic assignment that were present in both (A-D) diarrhoeal and (E-H) recovery phases is shown for each individual in the study. The number of 97%-identity OTUs with a given species assignment is shown in parentheses. Species are ordered based on their ‘indicator scores’ (defined as indicator value_(recovery) minus indicator value_(diarrhoea)). Age-discriminatory bacterial species incorporated into a Random-Forests-based model for defining relative microbiota maturity and microbiota-for-age z-scores³ in healthy Bangladeshi infants and children are marked with a ‘+’ symbol. The 97%-identity OTUs were derived from data sets generated from all samples from adult patients with cholera; the OTU table was rarefied to 49,000 reads per sample.

FIG. 18 depicts heatmaps and graphs showing the pattern of appearance of age-discriminatory 97%-identity OTUs in the faecal microbiota of patients with cholera mirrors the normal age-dependent pattern in the faecal microbiota of healthy Bangladeshi infants and children. (A-C) Shows hierarchical clustering of relative abundance values for each of the top 60 most age-discriminatory 97%-identity OTUs in a Random-Forests-based model of normal maturation of the microbiota in healthy Bangladeshi infants/children (importance scores for the age-discriminatory taxa defined by Random Forests analysis are reported in ref. 3; these 60 97%-identity OTUs can be grouped into 40 species-level taxa). (D-I) Presents the mean relative abundances of these OTUs in samples obtained from patients with cholera during (D-F) D-Ph1 to D-Ph4, and (G-I) R-Ph1 to R-Ph3. The 97%-identity OTUs corresponding to species included in the artificial community that was introduced into gnotobiotic mice are highlighted in blue. (J) Relative abundance of R. obeum strains in the faecal microbiota of healthy Bangladeshi children sampled monthly through the first 3 years of life. Mean values±s.e.m. are plotted.

FIG. 19 graphically depicts the pattern of recovery of the gut microbiota in patients with cholera. (A,B) Mean unweighted (A) and weighted (B) UniFrac distances to healthy adult controls at each of the defined phases of diarrhoea and recovery. (C,D) Principal coordinates analysis of UniFrac distances between gut microbiota samples. Location along the principal axis of variation (PC1) shows how acute diarrhoeal communities first resemble those of healthy Bangladeshi children sampled during the first 2 years of life, then evolve their phylogenetic configurations during the recovery phase towards those of healthy Bangladeshi adults. PC1 accounts for 34.3% variation for weighted and 17.7% variation for unweighted UniFrac values. (E) Alpha diversity (whole-tree phylogenetic diversity) measurements of faecal microbial communities through all study phases. Mean values±s.e.m. are plotted. *P<0.05, **P<0.01, ****P<0.0001 (Kruskal-Wallis analysis of variance followed by multiple comparisons test).

FIG. 20 depicts heatmaps showing the proportional representation of genes encoding enzymes (classified according to Enzyme Commission number identifiers) in faecal microbiomes sampled during the diarrhoeal and recovery phases of cholera. Shotgun sequencing of faecal community DNA was performed (MiSeq 2000 instrument; 2×250 bp paired-end reads; 341,701±145,681 reads (mean±s.d. per sample)). Read pairs were assembled (SHERA software package³⁴). Read counts were collapsed based on their assignment to Enzyme Commission (EC) number identifiers. The significance of differences in EC abundances compared with faecal microbiomes in healthy adult Bangladeshi controls was defined using ShotgunFunctionalizeR³⁹. Unsupervised hierarchical clustering identifies groups of ECs that characterize the faecal microbiomes of patients with cholera at varying diarrhoeal and recovery phases. (A-E) The heat map shows the results of EC-based clustering by phase (diarrhoea/recovery). (F-J) The heat map presents the results of a global clustering of all time-points and study phases. Genes encoding 102 ECs were identified with (1) at least 0.1% average relative abundance across the study and (2) significant differences in their representation relative to healthy microbiomes in at least one comparison (adjusted P<0.00001 based on ShotgunFunctionalizeR). In each of the heat maps, z-scores for each EC across all samples are plotted. ECs are grouped by KEGG level 1 assignment and further annotated based on their KEGG Pathway assignments. Note that the majority of the 46 ECs that were more prominently represented in faecal microbiomes during diarrhoeal phases in study participants are related to carbohydrate metabolism. The faecal microbiomes of patients during recovery are enriched for genes involved in vitamin and cofactor metabolism (Table 24).

FIG. 21 depicts a schematic and graph showing that R. obeum encodes a functional Al-2 system, and R. obeum Al-2 production is stimulated by the presence of V. cholerae. (A) Relative abundances of R. obeum and V. cholerae in the faecal microbiota after introduction of V. cholerae into mice harbouring the artificial 14-member human gut community (D14invasion group, see FIG. 15C,D). ‘Days post V. cholerae gavage’ refers to the second of two daily gavages of 10⁹ c.f.u. V. cholerae into animals that had been colonized 14 days earlier with the 14-member community. Mean values±s.e.m. are shown (n=4 or 5 mice, *P<0.05, unpaired Student's t-test). (B) Shows Al-2 signalling pathway components represented in the R. obeum genome. (C) Plots changes in expression of these components as defined by microbial RNA-seq of faecal samples obtained (1) 4 days after colonization of mice with the 14-member community and (2) 4 days after gavage of mice with the 14-member community together with 10⁹ c.f.u. of V. cholerae (n=4-6 animals per group; one faecal sample analysed per animal). Mean values±s.e.m. are shown. *P<0.05 (Mann-Whitney U-test). (D) RNA-seq of faecal samples collected at the time points and treatment groups indicated reveals that R. obeum luxS transcription is directly correlated to V. cholerae abundance in the context of the 14-member community. **P<0.01 (F test). (E) R. obeum luxS expression. Mice were colonized first with R. obeum for 7 day. Faecal samples were collected for microbial RNA-seq analysis 1 day before gavage of 10⁹ c.f.u. of a V. cholerae ΔluxS mutant, and then 2 days post-gavage (d2pg). Mean values for relative R. obeum luxS transcript levels (±s.e.m.) are shown (n=5 or 6 animals per group per experiment, n=3 independent experiments; **P<0.01 unpaired Mann-Whitney U-test). (F) Al-2 levels in faecal samples, taken 1 day before and 3 days after gavage of the V. cholerae ΔluxS strain, from the same mice as those analysed in (A). Al-2 levels were measured based on induction of bioluminescence in V. harveyi BB170 using the same mass of input faecal sample for all assays. Mean values±s.e.m. are shown; ****P<0.0001 (unpaired Mann-Whitney U-test). (G) R. obeum produces Al-2 when co-cultured with V. cholerae in vitro. Aliquots of the supernatant from cultures containing R. obeum alone, or R. obeum plus the V. cholerae ΔluxS mutant, were assayed for their ability to induce V. harveyi bioluminescence. Mean values±s.e.m. are presented (n=4 independent experiments). LU, light units; RPKM, reads per kilobase per million reads. ****P<0.0001 (unpaired Mann-Whitney U-test). Note that (1) the number of R. obeum c.f.u. present in the samples obtained from mono-cultures of the organism was similar to the number in co-culture, as measured by selective plating, and (2) the V. cholerae ΔluxSmutant cultured alone produced levels of Al-2 signal that were not significantly different from that of R. obeum in mono-culture (data not shown).

FIG. 22 graphically depicts UPLC-MS analysis of faecal bile acid profiles in gnotobiotic mice. Targeted UPLC-MS used methanol extracts of faecal pellets obtained from age- and gender-matched germ-free C57BL/6J mice and gnotobiotic mice colonized for 3 days with R. obeum alone, for 7 days with the 14-member community (‘D1 invasion group’), and for 3 days with the 13-member community that lacked R. obeum (n=4-6 mice per treatment group; one faecal sample analysed per animal). (A) Faecal levels of taurocholic acid. Mean values±s.e.m. are plotted. *P<0.05, **P<0.01, Mann-Whitney U-test. (B) Mean relative abundance of ten bile acid species in faecal samples obtained from the mice shown in (A).

FIG. 23 depicts a phylogenetic tree of luxS genes present in human gut bacterial symbionts and enteropathogens. (A-C) The tree was constructed from amino-acid sequence alignments using Clustal X. Red type indicates that the homologue is represented in the genomes of members of the 14-member artificial human gut bacterial community.

FIG. 24 graphically depicts in vivo tests of the effects of known quorum-sensing components on R. obeum-mediated reductions in V. cholerae colonization. (A) Competitive index of ΔluxP versus wild-type C6706 V. cholerae when colonized with or without R. obeum (n=4-6 animals per group). Horizontal bars, mean values. Data from individual animals are shown using the indicated symbols. (B) Transcript abundance (reads per kilobase per million reads) for selected quorum-sensing and virulence gene regulators in V. cholerae. Microbial RNA-seq was performed on faecal samples collected 2 days after mono-colonization of germ-free mice with V. cholerae (circles), or 2 days after V. cholerae was introduced into mice that had been mono-colonized for 7 days with R. obeum (squares) (n=5 animals per group; NS, not significant (P≥0.05); **P<0.01, ***P<0.001, ****P<0.0001 (unpaired two-tailed Student's t-test)).

DETAILED DESCRIPTION

Applicants have discovered that maturation of the gut microbiota in healthy subjects (i.e. normal maturation of the gut microbiota) can be characterized or defined by a minimal number of bacterial taxa whose relative abundance changes over time. Accordingly, the present invention provides a method to identify a set of bacterial taxa that define normal maturation of the gut microbiota. The set of bacterial taxa can also be used to characterize the maturity of a test subject's gut microbiota. Determining whether the maturation of a test subject's gut microbiota corresponds to the test subject's chronological age may be used to guide treatment decisions (e.g. an immature state may indicate a need to initiate or continue therapy) or evaluate the effectiveness of a therapy (e.g. no improvement or a worsening would indicate the therapy is not effective).

Applicants have also discovered a set of bacterial taxa that strongly correlate with normal maturation of the gut microbiota in healthy children and recovery from diseases that perturb a normal/healthy configuration of the gut microbiota in adults. Accordingly, the present invention provides methods for preventing and/or treating a disease in a subject in need thereof by administering a composition comprising one or more of those bacterial taxa. Useful combinations of bacterial taxa are disclosed herein.

The term “subject,” as used herein, refers to a mammal, including, but not limited to, a dog, a cat, a rat, a mouse, a hamster, a mouse, a cow, a horse, a goat, a sheep, a pig, a camel, a non-human primate, and a human. In a preferred embodiment, a subject is a human.

As used herein, a “healthy subject” is a subject with no known or diagnosed disease. The health of a subject may also be assessed by anthropometric measurements. For humans, the World Health Organization (WHO) Department of Nutrition for Health and Development has published a set of reference standards for individuals of about 19 years of age or less (WHO child growth standards growth velocity based on weight, length and head circumference: methods and development; World Health Organization, 2009; or current edition). Similar standards are known in the art for other subjects. The terms “healthy subject” and “normal subject” may be used interchangeably.

As used herein, a “subject in need of treatment” or a “subject in need thereof” is a subject in need of prophylaxis against, or treatment for, a disease, preferably a gastrointestinal disease. In some embodiments, a subject in need of treatment may be a healthy subject. For example, a healthy subject may have an increased risk of developing a disease relative to the population at large. In other embodiments, a subject in need of treatment may have a disease. In certain embodiments, a subject may have an immature microbiota and, therefore, may be in need of treatment. The phrase “microbiota immaturity” is described in detail in Section 1(C).

As used herein, the term “gut microbiota” refers to microbes that have colonized and inhabit the gastrointestinal tract of a subject. While various aspects of the present invention are exemplified with bacteria, the invention is applicable to all microbes including, but not limited to, archaea, bacteria, fungi, protists and viruses. A subject's gut microbiota may be naturally acquired or artificially established. Means by which a subject naturally acquires its gut microbiota are well known. Such examples may include, but are not limited to, exposure during birth, environmental exposure, consumption of foods, and coprophagy. Means by which a subject's gut microbiota may be artificially established are also well known. For example, artificially established gut microbial communities can be established in gnotobiotic animals by inoculating an animal with a defined or undefined consortium of microbes. Typically, a naturally acquired gut microbiota is comprised of both culturable and unculturable components. An artificially acquired gut microbiota may be similarly comprised of both culturable and unculturable components, or may consist of only culturable components. The phrase “culturable components” refers to the microbes comprising the gut microbiota that may be cultured in vitro using techniques known in the art. Culture collections of gut microbial communities are described in detail in PCT/US2012/028600, incorporated herein in its entirety by reference.

As used herein, the phrase “normal maturation of the gut microbiota” refers to the ordered change in the relative abundances of bacterial taxa in the gut microbiota over time, as determined from a group of healthy subjects.

As used herein, the phrase “chronological age of a subject” refers to the amount of time a subject has lived.

I. Normal Maturation of the Gut Microbiota

Applicants have discovered that the proportional representation of a minimal number of bacterial taxa defines a healthy gut microbiota as it assembles (i.e. matures). The changes in the relative abundance of these bacterial taxa over time are consistent across substantially all healthy subjects within the same age range. Accordingly, the present invention provides a method to accurately characterize the maturity of a subject's gut microbiota using a limited amount of information. This is exemplified in the Examples using a group of subjects between 0 and about 2 years of age. However, without wishing to be bound by theory, the gut microbiota of a human relatively stabilizes after about 2-3 years provided there are no insults. When there is an insult, the gut microbiota regresses to an immature state that can be discriminated using the relative abundances of these same bacterial taxa.

A. Methods to Define Normal Maturation of the Gut Microbiota Using a Limited Number of Bacterial Taxa

In an aspect, the present invention provides a method to define normal maturation of the gut microbiota using a limited number of bacterial taxa found in the gut microbiota. The relative abundances of these limited number of bacterial taxa, referred to herein as “age-discriminatory bacterial taxa”, in gut microbiota samples obtained from healthy subjects changes over time in a consistent way across substantially all healthy subjects within the same age range. Regressing the relative abundance of age-discriminatory taxa in their gut microbiota against the chronological age of each healthy subject at the time a sample of the gut microbiota was collected produces a regression model that may be used to characterize the maturity of another subject's gut microbiota to provide a measure of gastrointestinal health without having to query the whole microbiota.

A method for identifying a group of age-discriminatory taxa that define normal maturation of the gut microbiota is described in detail in the Examples. Briefly, a method for identifying a group of age-discriminatory bacterial taxa comprises (a) providing, for each healthy subject, a relative abundance for the bacterial taxa comprising the healthy subject's gut microbiota, wherein the relative abundance of the bacterial taxa in the subject's gut microbiome was determined from a plurality of gut microbiota samples obtained at intervals of time, (b) applying a regression analysis to model the relative abundance of the bacterial taxa comprising each healthy subject's gut microbiota against the amount of time the subject has lived (i.e. the chronological age of the healthy subject) at the time the gut microbiota sample was collected, and (c) selecting the minimum number of bacterial taxa needed for the model to predict gut microbiota age.

Methods for profiling the relative abundances of bacterial taxa in biological samples, including biological samples of gut microbiota, are well known in the art. Suitable methods may be sequencing-based or array-based. An exemplary method is detailed in the Examples. Briefly, the bacterial component of a gut microbiota sample is characterized by sequencing a nucleic acid suitable for taxonomic classification and assigning the sequencing reads to operational taxonomic units (OTUs) with ≥97% nucleotide sequence identity to a database of annotated and representative sequences. An example of such a database is Greengenes version 4feb2011; however any suitable database may be used. After OTUs are defined, a representative sequence from each OTU can be selected and compared to a reference set. If a match is identified in the reference set, that OTU can be given an identity. Relative abundance of a bacterial taxon may be defined by the number of sequencing reads that can be unambiguously assigned to each taxon after adjusting for genome uniqueness.

Generally speaking, a suitable nucleic acid used for taxonomic classification is universally distributed among the gut microbial population being queried allowing for the analysis of phylogenetic relationships among distant taxa, and has both a conserved region and at least one region subject to variation. The presence of at least one variable region allows sufficient diversification to provide a tool for classification, while the presence of conserved regions enables the design of suitable primers for amplification (if needed) and/or probes for hybridization for various taxa at different taxonomic levels ranging from individual strains to whole phyla. While any suitable nucleic acid known in the art may be used, one skilled in the art will appreciate that selection of a nucleic acid or region of a nucleic acid to amplify may differ by environment. In some embodiments, a nucleic acid queried is a small subunit ribosomal RNA gene. For bacterial and archaeal populations, at least the V1, V2, V3, V4, V5, V6, V7, V8 and/or V9 regions of the 16S rRNA gene are suitable, though other suitable regions are known in the art. Guidance for selecting a suitable 16S rRNA region to amplify can be found throughout the art, including Guo F et al. PLOS One 8(10) e76185, 2013; Soergel DAW et al. ISME Journal 6: 1440, 2012; and Hamady M et al. Genome Res. 19:1141, 2009, each hereby incorporated by reference in its entirety.

As used herein, “gut microbiota sample” refers to a biological sample comprising a plurality of heterogeneous nucleic acids produced by a subject's gut microbiota. Fecal samples are commonly used in the art to sample gut microbiota. Methods for obtaining a fecal sample from a subject are known in the art and include, but are not limited to, rectal swab and stool collection. Suitable fecal samples may be freshly obtained or may have been stored under appropriate temperatures and conditions known in the art. Methods for extracting nucleic acids from a fecal sample are also well known in the art. The extracted nucleic acids may or may not be amplified prior to being used as an input for profiling the relative abundances of bacterial taxa, depending upon the type and sensitivity of the downstream method. When amplification is desired, nucleic acids may be amplified via polymerase chain reaction (PCR). Methods for performing PCR are well known in the art. Selection of nucleic acids or regions of nucleic acids to amplify are discussed above. The nucleic acids comprising the nucleic acid sample may also be fluorescently or chemically labeled, fragmented, or otherwise modified prior to sequencing or hybridization to an array as is routinely performed in the art.

Gut microbiota samples may be obtained from a healthy subject at any suitable interval of time, varying from minutes to hours apart, days to weeks apart, or even weeks to months apart. Gut microbiota samples may be obtained multiple times a day, week, month or year. The duration of sampling can also vary. For example, the duration of sampling may be for about a month, about 6 months, about 1 year, about 2 years, about 3 years, about 4 years, about 5 years, about 6 years, about 7 years, about 8 years, about 9 years, about 10 years, about 11 years, about 12 years, about 13 years, about 14 years, about 15 years, about 16 years, about 17 years, about 18 years, about 19 years, about 20 years, about 30 years, or more.

The number of healthy subjects from which gut microbiota samples are obtained can and will vary. Generally, a suitable number is the number of healthy subjects needed to give the model produced by the regression analysis an acceptable degree of statistical significance. For example, the number of subject may be 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 or more subjects.

Any suitable machine learning algorithm may be used to regress relative abundances of bacterial taxa against the amount of time the healthy subject has lived at the time the gut microbiota sample was collected. Preferably, the algorithm is able to detect both linear and nonlinear relationships between the bacterial taxa and chronologic age. In an exemplary embodiment, the Random Forests machine learning algorithm is used. The regression analysis produces a model that is a prediction of the gut microbiota age based on the microbial taxa present in the subject's gut microbiota sample.

Before selecting a minimal number of bacterial taxa required to discriminate different periods of post-natal life, the importance of the bacterial taxa are first determined. An “importance score” for the bacterial taxa may be an output of the learning algorithm. Generally, a ranked list of all bacterial taxa, in order of “age-discriminatory importance” may be determined by considering those taxa, whose relative abundance values when permuted leads to a meaningful increase in the error. Bacterial taxa ranked higher on the list (e.g. 1, 2, 3) have a larger increase in error than those lower on the list (e.g. 61, 62, 63). To select a minimal number of bacterial taxa, the predictive performance of sets comprising increasing numbers of the top-ranking bacterial taxa may be evaluated, and when minimal improvements in the predictive performance are observed after adding a new member to the set, then a minimal number of bacterial taxa have been identified. An example of a minimal improvement may be when the root mean-squared error of prediction remains below about 4 or aobut 5 months.

These steps produce a “sparse model” that is a prediction of the gut microbiota age based only on the relative abundance of age-discriminatory bacterial taxa present in a sample of the subject's gut microbiota. Additional bacterial taxa may be added to the sparse model to improve the model's performance, though the overall contribution of the additional bacterial taxa is usually minimal.

B. Useful Groups of Bacterial Taxa to Define Normal Maturation of the Gut Microbiota

In another aspect, the present invention provides a group of bacterial taxa that define normal maturation of the gut microbiota (i.e. a group of age-discriminatory taxa). The phrase “normal maturation of the gut microbiota” is defined above. A group of bacterial taxa that define normal maturation of the gut microbiota can be used to characterize the maturity of a subject's gut microbiota. Stated another way, a group of bacterial taxa that define normal maturation of the gut microbiota can be used to determine whether the maturity of a subject's gut microbiota corresponds to what would be predicted by the subject's chronological age. Such information can be used to guide treatment decisions (e.g. an immature state may indicate a need to initiate or continue therapy) or evaluate the effectiveness of a therapy (e.g. no improvement or a worsening would indicate the therapy is not effective).

In some embodiments, a group of bacterial taxa that define normal maturation of the gut microbiota in may comprise at least 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, or at least 59 of the bacterial taxa listed in Table A. In preferred embodiments, a group of bacterial taxa that define normal maturation of the gut microbiota in may comprise at least 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, or at least 59 of the bacterial taxa listed in Table A.A bacterial isolate can be identified as belonging to a bacterial taxon listed in Table A if the V4 region of the 16S rRNA gene of the bacterial isolate has at least 97% sequence identity to any of SEQ ID NOs: 1-60. For example, the V4 region of the 16S rRNA gene of the bacterial isolate can have 97%, 97.5%, 98%, 98.5%, 99%, 99.5%, or 100% sequence identity to any of SEQ ID NOs: 1-60.

TABLE A ROW SEQ NO. ID NO. Bacterial Taxon 1 1 Faecalibacterium prausnitzii OTU ID 326792 2 2 Ruminococcus sp. 5 1 39BFAA OTU ID 189827 3 3 Lactobacillus ruminis OTU ID 470663 4 4 Dorea longicatena OTU ID 191687 5 5 Bifidobacterium longum OTU ID 72820 6 6 Ruminococcus sp. 5 1 39BFAA OTU ID 194745 7 7 Lactobacillus mucosae OTU ID 15141 8 8 Bifidobacterium OTU ID 561483 9 9 Staphylococcus OTU ID 217996 10 10 Ruminococcus sp. 5 1 39BFAA OTU ID 364234 11 11 Catenibacterium mitsuokai OTU ID 287510 12 12 Dorea formicigenerans OTU ID 261912 13 13 Ruminococcus torques OTU ID 361809 14 14 Streptococcus thermophilus OTU ID 108747 15 15 Bifidobacterium sp. OTU ID 533785 16 16 Haemophilus parainfluenzae OTU ID 9514 17 17 Streptococcus sp. OTU ID 561636 18 18 Clostridium sp. OTU ID 312461 19 19 Clostridium ramosum OTU ID 470139 20 20 Clostridium sp. OTU ID 181834 21 21 Weissella cibaria OTU ID 148099 22 22 Bifidobacterium sp. OTU ID 469873 23 23 Clostridiales sp. OTU ID 185951 24 24 Ruminococcaceae sp. OTU ID 212619 25 25 Bifidobacterium bifidum OTU ID 469852 26 26 Eubacterium desmolans OTU ID 170124 27 27 Faecalibacterium prausnitzii OTU ID 187010 28 28 Prevotella copri OTU ID 303304 29 29 Lactobacillus reuteri OTU ID 470527 30 30 Enterobacteriaceae sp. OTU ID 210269 31 31 Clostridium glycolicum OTU ID 182202 32 32 Ruminococcus obeum OTU ID 178122 33 33 Enterococcus faecalis OTU ID 540230 34 34 Prevotella copri OTU ID 309068 35 35 Bifidobacterium sp. OTU ID 24773 36 36 Enterococcus sp. OTU ID 554755 37 37 Escherichia coli OTU ID 305760 38 38 Prevotella sp. OTU ID 268604 39 39 Faecalibacterium prausnitzii OTU ID 188900 40 40 Eubacterium hallii OTU ID 174256 41 41 Bacteroides fragilis OTU ID 130663 42 42 Streptococcus sp. OTU ID 292424 43 43 Staphylococcus sp. OTU ID 269541 44 44 Ruminococcus sp. 5 1 39BFAA OTU ID 191900 45 45 Dialister sp. OTU ID 48207 46 46 Collinsella aerofaciens OTU ID 186029 47 47 Clostridium bartlettii OTU ID 325608 48 48 Lactobacillus sp. OTU ID 252321 49 49 Prevotella sp. OTU ID 195574 50 50 Ruminococcus sp. 5 1 39BFAA OTU ID 365047 51 51 Lactobacillus ruminis OTU ID 471308 52 52 Enterobacteriaceae sp. OTU ID 307981 53 53 Streptococcus sp. OTU ID 15382 54 54 Clostridium disporicum OTU ID 302844 55 55 Streptococcus parasanguinis OTU ID 528842 56 56 Bifidobacterium sp. OTU ID 131391 57 57 Megamonas sp. OTU ID 259261 58 58 Clostridium sp. OTU ID 248563 59 59 Megasphaera sp. OTU ID 162427 60 60 Lactobacillus sp. OTU ID 545371 The SEQ ID NO can be used to identify the representative 16S rRNA sequence for the OTU ID (OTU ID = 16S rRNA OTU ID corresponding to Greengenes version 4 Feb. 2011).

In other embodiments, a group of bacterial taxa that define normal maturation of the gut microbiota comprises (a) at least 12 bacterial taxa listed in Table B; and (b) at least 12 bacterial taxa listed in Table C. In other embodiments, a group of bacterial taxa that define normal maturation of the gut microbiota comprises (a) at least 16 bacterial taxa listed in Table B; and (b) at least 8 bacterial taxa listed in Table C. In other embodiments, a group of bacterial taxa that define normal maturation of the gut microbiota comprises (a) at least 20 bacterial taxa listed in Table B; and (b) at least 4 bacterial taxa listed in Table C. In other embodiments, a group of bacterial taxa that define normal maturation of the gut microbiota comprises the bacterial taxa listed in Table B. In other embodiments, a group of bacterial taxa that define normal maturation of the gut microbiota consists of the bacterial taxa listed in Table B. A bacterial isolate can be identified as belonging to a bacterial taxon listed in Table B or Table C if the V4 region of the 16S rRNA gene of the bacterial isolate has at least 97% sequence identity to any of SEQ ID NOs: 1-24 (Table A), or 25-60 (Table B). For example, the V4 region of the 16S rRNA gene of the bacterial isolate can have 97%, 97.5%, 98%, 98.5%, 99%, 99.5%, or 100% sequence identity to any of SEQ ID NOs: 1-60.

TABLE B ROW SEQ NO. ID NO. Bacterial Taxon 1 1 Faecalibacterium prausnitzii OTU ID 326792 2 2 Ruminococcus sp. 5 1 39BFAA OTU ID 189827 3 3 Lactobacillus ruminis OTU ID 470663 4 4 Dorea longicatena OTU ID 191687 5 5 Bifidobacterium longum OTU ID 72820 6 6 Ruminococcus sp. 5 1 39BFAA OTU ID 194745 7 7 Lactobacillus mucosae OTU ID 15141 8 8 Bifidobacterium OTU ID 561483 9 9 Staphylococcus OTU ID 217996 10 10 Ruminococcus sp. 5 1 39BFAA OTU ID 364234 11 11 Catenibacterium mitsuokai OTU ID 287510 12 12 Dorea formicigenerans OTU ID 261912 13 13 Ruminococcus torques OTU ID 361809 14 14 Streptococcus thermophilus OTU ID 108747 15 15 Bifidobacterium sp. OTU ID 533785 16 16 Haemophilus parainfluenzae OTU ID 9514 17 17 Streptococcus sp. OTU ID 561636 18 18 Clostridium sp. OTU ID 312461 19 19 Clostridium ramosum OTU ID 470139 20 20 Clostridium sp. OTU ID 181834 21 21 Weissella cibaria OTU ID 148099 22 22 Bifidobacterium sp. OTU ID 469873 23 23 Clostridiales sp. OTU ID 185951 24 24 Ruminococcaceae sp. OTU ID 212619 The SEQ ID NO can be used to identify the representative 16S rRNA sequence for the OTU ID (OTU ID = 16S rRNA OTU ID corresponding to Greengenes version 4 Feb. 2011).

TABLE C ROW SEQ NO. ID NO. Bacterial Taxon 1 25 Bifidobacterium bifidum OTU ID 469852 2 26 Eubacterium desmolans OTU ID 170124 3 27 Faecalibacterium prausnitzii OTU ID 187010 4 28 Prevotella copri OTU ID 303304 5 29 Lactobacillus reuteri OTU ID 470527 6 30 Enterobacteriaceae sp. OTU ID 210269 7 31 Clostridium glycolicum OTU ID 182202 8 32 Ruminococcus obeum OTU ID 178122 9 33 Enterococcus faecalis OTU ID 540230 10 34 Prevotella copri OTU ID 309068 11 35 Bifidobacterium sp. OTU ID 24773 12 36 Enterococcus sp. OTU ID 554755 13 37 Escherichia coli OTU ID 305760 14 38 Prevotella sp. OTU ID 268604 15 39 Faecalibacterium prausnitzii OTU ID 188900 16 40 Eubacterium hallii OTU ID 174256 17 41 Bacteroides fragilis OTU ID 130663 18 42 Streptococcus sp. OTU ID 292424 19 43 Staphylococcus sp. OTU ID 269541 20 44 Ruminococcus sp. 5 1 39BFAA OTU ID 191900 21 45 Dialister sp. OTU ID 48207 22 46 Collinsella aerofaciens OTU ID 186029 23 47 Clostridium bartlettii OTU ID 325608 24 48 Lactobacillus sp. OTU ID 252321 25 49 Prevotella sp. OTU ID 195574 26 50 Ruminococcus sp. 5 1 39BFAA OTU ID 365047 27 51 Lactobacillus ruminis OTU ID 471308 28 52 Enterobacteriaceae sp. OTU ID 307981 29 53 Streptococcus sp. OTU ID 15382 30 54 Clostridium disporicum OTU ID 302844 31 55 Streptococcus parasanguinis OTU ID 528842 32 56 Bifidobacterium sp. OTU ID 131391 33 57 Megamonas sp. OTU ID 259261 34 58 Clostridium sp. OTU ID 248563 35 59 Megasphaera sp. OTU ID 162427 36 60 Lactobacillus sp. OTU ID 545371 The SEQ ID NO can be used to identify the representative 16S rRNA sequence for the OTU ID (OTU ID = 16S rRNA OTU ID corresponding to Greengenes version 4 Feb. 2011). C. Method for Characterizing the Maturity of a Subject's Gut Microbiota

In another aspect, the present invention provides a method to determine the maturity of a subject's gut microbiota. The method may comprise: (a) calculating a relative abundance for each bacterial taxon in a group bacterial taxa, from a fecal sample obtained from the subject; (b) applying the relative abundances of the bacterial taxa from step (a) to a regression model to determine a microbiota age for the subject's gut microbiota, wherein the model regresses, for a group of healthy subjects, relative abundances of the same bacterial taxa, as determined from a plurality of gut microbiota samples obtained over time for each healthy subject in the group, against the chronological age of each healthy subject in the group at the time the gut microbiota sample was collected; and (c) calculating the maturity of the subject's gut microbiota using the subject's microbiota age. In some embodiments, the calculation for maturity is defined as relative maturity, and relative maturity=(microbiota age of the subject)−(microbiota age of a healthy subject of a similar chronological age). In other embodiments, the calculation for maturity is defined as a Microbiota-for-Age Z score (MAZ), wherein MAZ=((microbiota age of the subject)−(median microbiota age of a healthy subject of a similar chronological age))/(standard deviation of microbiota age of healthy subjects of the similar chronological age). In each embodiment above, the group of bacterial taxa can be a group described above in Section I(B), which are incorporated into this Section by reference. Alternatively, the group of bacterial taxa can be identified using a method described in Section I(A), which are incorporated into this Section by reference. Methods for calculating a relative abundance for a bacterial taxon are described in Section I(A). In a preferred embodiment, the subject is human that is about 2 years of age or less. In another preferred embodiment, the subject is a human that is about 5 years of age or less. In another preferred embodiment, the subject is a human that is about 10 years of age or less. In another preferred embodiment, the subject is a human that is about 20 years of age or less. In another preferred embodiment, the subject is a human that is about 30 years of age or less. In another preferred embodiment, the subject is a human that is about 40 years of age or less. In another preferred embodiment, the subject is a human that is about 50 years of age or less. In another preferred embodiment, the subject is a human that is about 60 years of age or less. In another preferred embodiment, the subject is a human that is about 70 years of age or less. In another preferred embodiment, the subject is a human that is about 80 years of age or less. In another preferred embodiment, the subject is a human that is about 90 years of age or less. In another preferred embodiment, the subject is a human that is about 100 years of age or less. In another preferred embodiment, the subject is a human that is about 110 years of age or less. In exemplary embodiments, the group of bacterial taxa is a group listed in Table A or Table B.

In another aspect, the present invention provides a method to classify a subject. For example, because the relative abundances of the age-discriminatory taxa change in a consistent way that corresponds to the chronological age of healthy subjects, it is also possible to classify the maturity of a subject's gut microbiota as perturbed if the abundances of the age-discriminatory taxa are not as predicted by the subject's chronological age. Within the classification of “perturbed maturation, a subject may an immature gut microbiota (i.e. the subject's microbiota age is less than predicted by chronological age alone), or a subject may have a gut microbiota that matured faster than normal (i.e. the subject's microbiota age is less than predicted by chronological age alone).

A method to classify a subject may comprise: (a) calculating a relative abundance for each bacterial taxon in a group bacterial taxa, from a fecal sample obtained from the subject; (b) applying the relative abundances of the bacterial taxa from step (a) to a regression model to determine a microbiota age for the subject's gut microbiota, wherein the model regresses, for a group of healthy subjects, relative abundances of the same bacterial taxa, as determined from a plurality of gut microbiota samples obtained over time for each healthy subject in the group, against the chronological age of each healthy subject in the group at the time the gut microbiota sample was collected; and (c) classifying the subject as having normal gut maturation when the microbiota age of the subject is substantially similar to the microbiota age of a healthy subject of a similar age. The group of bacterial taxa can be a group described above in Section I(B), which are incorporated into this Section by reference. Alternatively, the group of bacterial taxa can be identified using a method described in Section I(A), which are incorporated into this Section by reference. Methods for calculating a relative abundance for a bacterial taxon are described in Section I(A). In a preferred embodiment, the subject is human that is about 2 years of age or less. In another preferred embodiment, the subject is a human that is about 5 years of age or less. In another preferred embodiment, the subject is a human that is about 10 years of age or less. In another preferred embodiment, the subject is a human that is about 20 years of age or less. In another preferred embodiment, the subject is a human that is about 30 years of age or less. In another preferred embodiment, the subject is a human that is about 40 years of age or less. In another preferred embodiment, the subject is a human that is about 50 years of age or less. In another preferred embodiment, the subject is a human that is about 60 years of age or less. In another preferred embodiment, the subject is a human that is about 70 years of age or less. In another preferred embodiment, the subject is a human that is about 80 years of age or less. In another preferred embodiment, the subject is a human that is about 90 years of age or less. In another preferred embodiment, the subject is a human that is about 100 years of age or less. In another preferred embodiment, the subject is a human that is about 110 years of age or less. In exemplary embodiments, the group of bacterial taxa is a group listed in Table A or Table B.

Alternatively, a method to classify a subject may comprise: (a) calculating a relative abundance for each bacterial taxon in a group, from a fecal sample obtained from the subject; (b) using the relative abundances of the bacterial taxa from step (a) and chronologic age of the subject to indicate the health status of the subject's gut microbiota (e.g. healthy or unhealthy; normal maturation of the gut microbiota or perturbed maturation of the gut microbiota) using a classification model; wherein the classification model is trained on datasets comprising measurements obtained from a plurality of healthy subjects and a plurality undernourished subjects. For example, the datasets may contain measurements from at least 4, 5, 6, 7, 8, 9, 10, 11, 12, or more healthy subjects and at least 4, 5, 6, 7, 8, 9, 10, 11, 12, or more undernourished subjects. The undernourished subjects may be subjects with acute malnutrition, moderate acute malnutrition, or at risk for moderate acute malnutrition, as defined in Section II. The measurements may at least include relative abundances of the same bacterial taxa from step (a) above from samples of the health and undernourished subjects' gut microbiota obtained over time for each subject, and the chronological age of the subject at the time the gut microbiota sample was collected. Additional measurements may optionally include MUAC measurements (as defined in Section II), WHZ measurements ((as defined in Section II), and other anthropometric measurements, as well as measurements such as a response to therapy. The group of bacterial taxa can be a group described above in Section I(B), which are incorporated into this Section by reference. Alternatively, the group of bacterial taxa can be identified using a method described in Section I(A), which are incorporated into this Section by reference. Methods for calculating a relative abundance for bacterial taxon are described in Section I(A). In a preferred embodiment, the subject is human that is about 2 years of age or less. In another preferred embodiment, the subject is a human that is about 5 years of age or less. In another preferred embodiment, the subject is a human that is about 10 years of age or less. In another preferred embodiment, the subject is a human that is about 20 years of age or less. In exemplary embodiments, the group of bacterial taxa is a group listed in Table A or Table B.

D. Method for Identifying the Effect of a Therapy

In another aspect, the present invention provides a method for identifying an effect of a therapy.

In some embodiments, a method for identifying an effect of a therapy may comprise (a) calculating a relative abundance for each bacterial taxon in a group, from a fecal sample obtained from the subject before and after administration of the therapy; (b) applying the relative abundances of the bacterial taxa from step (a) to a regression model to determine a microbiota age for the subject's gut microbiota before and after therapy, wherein the model regresses, for a group of healthy subjects, relative abundances of the same bacterial taxa, as determined from a plurality of gut microbiota samples obtained over time for each healthy subject in the group, against the chronological age of each healthy subject in the group at the time the gut microbiota sample was collected; wherein the therapy has an effect when the microbiota age of the subject changes after therapy. When the effect is positive, the microbiota age of the subject increases. When the effect is negative, the microbiota age of the subject decreases. The group of bacterial taxa can be a group described above in Section I(B), which are incorporated into this Section by reference. Alternatively, the group of bacterial taxa can be identified using a method described in Section I(A), which are incorporated into this Section by reference. Methods for calculating a relative abundance for a bacterial taxon are described in Section I(A). In a preferred embodiment, the subject is human that is about 2 years of age or less. In another preferred embodiment, the subject is a human that is about 5 years of age or less. In another preferred embodiment, the subject is a human that is about 10 years of age or less. In another preferred embodiment, the subject is a human that is about 20 years of age or less. In another preferred embodiment, the subject is a human that is about 30 years of age or less. In another preferred embodiment, the subject is a human that is about 40 years of age or less. In another preferred embodiment, the subject is a human that is about 50 years of age or less. In another preferred embodiment, the subject is a human that is about 60 years of age or less. In another preferred embodiment, the subject is a human that is about 70 years of age or less. In another preferred embodiment, the subject is a human that is about 80 years of age or less. In another preferred embodiment, the subject is a human that is about 90 years of age or less. In another preferred embodiment, the subject is a human that is about 100 years of age or less. In another preferred embodiment, the subject is a human that is about 110 years of age or less. In exemplary embodiments, the group of bacterial taxa is a group listed in Table A or Table B.

In other embodiments, a method for identifying an effect of a therapy may comprise (a) identifying a set of age-discriminatory bacterial taxa within the bacterial taxa comprising the gut microbiota a group of healthy subject's gut microbiota, the method comprising (i) providing, for each healthy subject, a relative abundance for the bacterial taxa comprising the subject's gut microbiota, wherein the relative abundance of the bacterial taxa in the healthy subject's gut microbiota was determined from a plurality of gut microbiota samples obtained at intervals of time; (ii) regressing the relative abundances of the bacterial taxa comprising each healthy subject's gut microbiota against the chronological age of the healthy subject at the time the gut microbiota sample was collected, thereby producing a prediction of a gut microbiota age that is based only on the relative abundance of age-discriminatory bacterial taxa present in the subject's gut microbiota; and (iii) selecting the minimum number of bacterial taxa from step (ii) that is needed to produce a prediction that is substantially similar to or better than the prediction of step (ii); calculating a relative abundance for each bacterial taxon in the set of age-discriminatory taxa from step (a)(iii), using a fecal sample obtained from a subject before and after administration of the therapy; and applying the relative abundances from step (b) to the prediction of gut microbiota age from step (a)(iii) to determine the microbiota age of the subject's gut microbiota before and after therapy; wherein the therapy has an effect when the microbiota age of the subject changes after therapy. When the effect is positive, then the microbiota age of the subject increases. When the effect is negative, then the microbiota age of the subject decreases. Methods for calculating a relative abundance for a bacterial taxon are described in Section I(A). In a preferred embodiment, the subject is human that is about 2 years of age or less. In another preferred embodiment, the subject is a human that is about 5 years of age or less. In another preferred embodiment, the subject is a human that is about 10 years of age or less. In another preferred embodiment, the subject is a human that is about 20 years of age or less. In another preferred embodiment, the subject is a human that is about 30 years of age or less. In another preferred embodiment, the subject is a human that is about 40 years of age or less. In another preferred embodiment, the subject is a human that is about 50 years of age or less. In another preferred embodiment, the subject is a human that is about 60 years of age or less. In another preferred embodiment, the subject is a human that is about 70 years of age or less. In another preferred embodiment, the subject is a human that is about 80 years of age or less. In another preferred embodiment, the subject is a human that is about 90 years of age or less. In another preferred embodiment, the subject is a human that is about 100 years of age or less. In another preferred embodiment, the subject is a human that is about 110 years of age or less.

II. Method of Preventing and/or Treating a Disease

In another aspect, the present invention provides a method for preventing and/or treating a disease in a subject in need thereof. As described in detail in the Examples, Applicants have discovered that certain bacterial taxa associated with normal maturation of the gut microbiota in healthy subjects (i.e. age-discriminatory taxa) are also associated with repair of the gut microbiota (i.e. recovery-indicative taxa) in subjects whose gut communities have been affected by a variety of insults (e.g. malnutrition or gastrointestinal disease). Accordingly, a method for preventing and/or treating a disease in a subject in need thereof may comprise administering to the subject a therapeutically effective amount of one or more age-indicative taxa associated with repair of the gut microbiota.

As used herein, “preventing” a disease refers to reducing the onset of symptoms or complications of a disease, condition or disorder (collectively, a “disease”), or the disease itself. Preventing a disease may involve reducing in treated subjects (e.g. a normal subject) (1) the incidence, development or formation of disease, (2) the development, duration, and/or severity of symptoms of disease, (3) death rates, or (4) a combination thereof. In each embodiment, the amount of reduction may each be about 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, 95% or about 100% in treated subjects, as compared to untreated subjects. For an infectious disease (e.g. enteropathogenic infection), preventing a disease may also involve increasing the median infectious disease dose (ID₅₀) by about 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, 95%, 100%, or more. Preventing a disease may also involve increasing the (relative) microbiota maturity, increasing bacterial diversity, increasing MAZ score.

As used herein, “treating” describes the management and care of a patient for the purpose of combating a disease in a subject. Treating a disease may involve reducing in treated subjects (1) the infectious burden (e.g. viral, bacterial, patristic load), (2) the duration and/or severity of symptoms of disease, (3) death rates, or (4) a combination thereof. In each embodiment, the amount of reduction may each be about 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, 95% or about 100% in treated subjects, as compared to untreated subjects. Treating a disease may also involve increasing the (relative) microbiota maturity, increasing bacterial diversity, increasing MAZ score.

As used herein, “therapeutically effective amount” means an amount of one or more bacterial taxa of the invention that will elicit a desired biological or medical response of a tissue, system, or subject that is being sought by a researcher or clinician. In one aspect, the biological or medical response is prevention or treatment of a gastrointestinal disease. In another aspect, the biological or medical response is prevention or treatment of a gastrointestinal disease caused by an enteropathogenic infection. In another aspect, the biological or medical response is treatment or prevention of acute malnutrition. In another aspect, the biological or medical response is treatment or prevention of acute diarrheal disease. In another aspect, the biological or medical response is treatment or prevention of acute diarrheal disease caused by an enteropathogenic infection. In another aspect, the biological or medical response is treatment or prevention of chronic diarrheal disease.

As used herein, the phrase “bacterial taxa of the invention” refers to age-discriminatory bacterial taxa associated with repair of the gut microbiota. Methods for identifying age-discriminatory bacterial taxa are described in detail in Section I. In some embodiments, one or more bacterial taxa of the invention are selected from the group listed in Table A. In other embodiments, one or more bacterial taxa of the invention are selected from the group listed in Table B. In other embodiments, one or more bacterial taxa of the invention are selected from the group listed in Table C. Preferred combinations of bacterial taxa of the invention include, but are not limited to the combinations listed in Table D, or further described in Section III. Preferred combinations of bacterial taxa of the invention may also be identified by testing for a therapeutic effect in an appropriate animal model. Combinations may also be selected by identifying bacterial taxa associated with repair of the gut microbiota that are under-represented in a subject's gut microbiota as compared to a healthy subject. Section III also describes in further detail formulations comprising bacterial taxa of the invention for administration to a subject. Bacterial taxa of the invention are preferably administered orally or rectally. A bacterial taxon administered to a subject is isolated and biologically pure. A bacterial isolate can be identified as belonging to a bacterial taxon listed in Tables A-D if the V4 region of the 16S rRNA gene of the bacterial isolate has at least 97% sequence identity to any of SEQ ID NOs: 1-60. For example, the V4 region of the 16S rRNA gene of the bacterial isolate can have 97%, 97.5%, 98%, 98.5%, 99%, 99.5%, or 100% sequence identity to any of SEQ ID NOs: 1-60. The duration of therapy can and will vary, depending at least in part upon the disease and the severity of the disease. In subjects with an immature gut microbiota, one or more bacterial taxa of the invention may be administered until the microbiota age of the subject is similar to the microbiota age of a healthy subject of the same chronological age.

As used herein, “gastrointestinal diseases” refer to diseases involving the gastrointestinal tract. In some embodiments, the disease is malnutrition. In other embodiments, the disease is an infection caused by an enteropathogen. Non-limiting examples of enteropathogens include Escherichia coli (e.g. enterotoxigenic E. coli, enteropathogenic E. coli, enteroinvasive E. coli, enterohemorrhagic E. coli, enteroaggregative E. coli, etc.), Salmonella enterica, Shigella sp. (e.g. S. flexneri, S. sonnei, S. dysenteriae, etc.), Camplobacter sp. (e.g. C. jejuni, C. coli, C. upsaliensis, etc.), Yersinia sp. (e.g. Y. enterocolitica, Y. pseudotuberculosis, etc.), Vibrio sp. (e.g. Vibrio cholera, Vibrio parahaemolyticus, etc.) Clostridum sp. (C. difficile), Entamoeba sp. (e.g. Entamoeba histolytica, Entamoeba dispar, etc.) Endolimax nana, Iodamoeba butschii, Chilomastix mesnili, Blastocystis hominis, Trichomonas hominis, Coccidian-like body, Giardia sp. (e.g. Giardia intestinalis, Giardia lamblia, etc.) Cryptosporidium parvum, Isospora belli, Dientamoeba fragilis, Microsporidia, Strongyloides stercoralis, Angiostrongylus costaricensis, Schistosoma sp. (e.g. S. mansoni, S. japonicum, etc.) Cyclospora cayetanensis, Enterocytozoon sp. (e.g. Enterocytozoon bieneusi, Enterocytozoon helium, etc.) Encephalitozoon sp. (e.g. Encephalitozoon intestinalis, Encephalitozoon cuniculi, etc.) Ascaris lumbricoides, Trichuris tricuria, Ancylostoma duodenale, Necator americanus, Hymenolepsis nana, rotaviruses, human caliciviruses (e.g. noroviruses and sapoviruses), astroviruses, cytolomegaloviruses. In other embodiments, the disease is ulcerative colitis, necrotizing enterocolitis, or Crohn's disease. In still other embodiments, the disease is traveler's diarrhea. In a preferred embodiment, the disease is acute malnutrition. In another preferred embodiment, the disease is an enteropathogen infection that has as a symptom acute diarrhea. In an exemplary embodiment, the disease is a Vibrio cholerae infection.

Acute malnutrition results from decreased food consumption and/or illness resulting in sudden weight loss. It is associated with greater risk of medical complications and infections, increased risk of death from illness and infections, and micronutrient deficiencies. Non-limiting examples of micronutrient deficiencies associated with acute malnutrition are iron deficiency, iodine deficiency, and vitamin A deficiency. The most common way to assess malnutrition, particularly in humans of about 19 years of age or less, is through anthropometric measurements. It is usually diagnosed in one of three ways: by weighing a subject and measuring the subject's height; by measuring the circumference of the subject's mid-upper arm (MUAC); and/or by checking for oedema in the subject's lower legs or feet. Acute malnutrition is divided into two types: severe acute malnutrition (SAM) and moderate acute malnutrition (MAM). A subject is classified as having SAM if the subject's weight-for-height Z-scores (WHZ) is below three standard deviations (−3 s.d.) from the median of the World Health Organization (WHO) reference growth standards. A subject with a WHZ between −2 s.d. and −3 s.d. from the median of the WHO reference growth standards is categorized as having MAM. If a subject is between about six months and about five years of age, a MUAC measurement of less than 12.5 cm also indicates that a subject is suffering from moderate acute malnutrition. Finally, the presence of oedema in both feet and lower legs of a subject is a sign of SAM. WHO reference growth standards are available from the WHO. See for example, World Health Organization Department of Nutrition for Health and Development: WHO child growth standards growth velocity based on weight, length and head circumference: methods and development; World Health Organization, 2009, or the current edition.

In some embodiments, the subject to be treated is a subject with acute malnutrition and a therapeutically effective amount of one or more bacterial taxa of the invention is administered to the subject. Treating acute malnutrition may involve reducing in treated subjects the duration and/or severity of symptoms of acute malnutrition, death rates associated with acute malnutrition, or a combination thereof. In each embodiment, the amount of reduction may each be about 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, 95% or about 100% in treated subjects, as compared to untreated subjects. Treating acute malnutrition may also involve increasing a suitable anthropometric measurement in a treated subject including, but not limited to, a subject's WHZ or MUAC. For each aspect, the amount of increase may each be about 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, 95% or about 100% in treated subjects, as compared to untreated subjects or as compared to the treated subject prior to administration of the combination of the invention. In certain embodiments, a subject's WHZ may improve to less than −3.0 s.d., less than −2.5 s.d., less than −2.0 s.d., less than −1.5 s.d., less than −1.0 s.d., or less than −0.5 s.d. from the median of the WHO reference growth standards. Treating acute malnutrition may also result in no worsening (i.e. decrease) in a subject's WHZ or MUAC. Treating acute malnutrition may also involve increasing the subject's relative gut microbiota maturity, MAZ score, gut microbiota diversity, or a combination thereof. The duration of treatment can and will vary. In certain embodiments, the duration of therapy is about 1, 2, 3, or 4 months. In other embodiments, the duration of therapy is about 1, 2, 3, 4, 5, 6, 7, or 8 weeks. In still other embodiments, the duration of therapy is about 4 to about 12 weeks, about 6 to about 10 weeks, or about 6 to about 8 weeks. Alternatively, a subject may be administered one or more bacterial taxa of the invention for as long as acute malnutrition persists. Useful combinations are described in further detail below. One or more bacterial taxa of the invention may be formulated for oral or rectal administration, and may be administered alone or with an additional therapeutic agent. Non-limiting examples of additional therapeutic agents include therapeutic foods, probiotics, antibiotics and vaccines. In exemplary embodiments, a subject with acute malnutrition is administered a therapeutically effective amount of one or more bacterial taxa of the invention and a therapeutic food. As used herein, “therapeutic food” refers to a food designed for specific, usually nutritional, therapeutic purposes as a form of dietary supplement. Therapeutic foods are usually made of a mixture of protein, carbohydrate, lipid and vitamins and minerals, and are usually produced by grinding all ingredients together, mixing them and packaging without water. The term “therapeutic foods” includes ready-to-use-therapeutic foods (RUTFs). Generally speaking, RUTFs are homogenous mixtures of lipid-rich and water-soluble foods. The lipids used in formulating RUTFs are in a viscous liquid form, and the other ingredients (e.g. protein, carbohydrate, vitamins, minerals) are mixed through the lipids. Non-limiting examples of therapeutic foods include F-75, F-100, K-Mix 2, Citadel spread, Plumpy'nut, Medika Mamba, Ensure, Fortisip, Energyzip, TwoCal, BP-100, and eeZee.

In other embodiments, the subject to be treated is a subject at risk for acute malnutrition and a therapeutically effective amount of one or more bacterial taxa of the invention is administered to the subject. A subject at risk for acute malnutrition may have limited access to nutritious foods and/or may have frequent exposure to infectious diseases. A subject at risk for acute malnutrition may also be a subject with a WHZ between 0 s.d. and −2 s.d., between −1 s.d and −2 s.d, or between −1.5 s.d and −2 s.d from the median of the WHO reference growth standards. Treating a subject at risk for acute malnutrition may prevent acute malnutrition in the subject. For example, preventing acute malnutrition may involve reducing in treated subjects (1) the incidence, development or formation of acute malnutrition, (2) the development, duration, and/or severity of symptoms of malnutrition, if malnutrition does develop, (3) death rates associated with acute malnutrition, or (4) a combination thereof. In each embodiment, the amount of reduction may each be about 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, 95% or about 100% in treated subjects, as compared to untreated subjects. Preventing acute malnutrition may also involve increasing a suitable anthropometric measurement in a treated subject including, but not limited to, a subject's WHZ or MUAC. For each aspect, the amount of increase may each be about 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, 95% or about 100% in treated subjects, as compared to untreated subjects or as compared to the treated subject prior to administration of the combination of the invention. In certain embodiments, a subject's WHZ may improve to less than −1.5 s.d., less than −1.0 s.d., or less than −1.5 s.d. from the median of the WHO reference growth standards. Preventing acute malnutrition may also result in no worsening (i.e. decrease) in a subject's WHZ or MUAC. Preventing acute malnutrition may also involve increasing the subject's relative gut microbiota maturity, MAZ score, gut microbiota diversity, or a combination thereof. The duration of treatment can and will vary. In certain embodiments, the duration of therapy is about 1, 2, 3, or 4 months. In other embodiments, the duration of therapy is about 1, 2, 3, 4, 5, 6, 7, or 8 weeks. In still other embodiments, the duration of therapy is about 4 to about 12 weeks, about 6 to about 10 weeks, or about 6 to about 8 weeks. Alternatively, a subject may be administered one or more bacterial taxa of the invention for as long as the subject remains at risk. Useful combinations are described in further detail below. One or more bacterial taxa of the invention may be formulated for oral or rectal administration, and may be administered alone or with an additional therapeutic agent. Non-limiting examples of additional therapeutic agents include therapeutic foods, antibiotics and/or vaccines.

As used herein, acute diarrhea is defined as three or more stools per day of decreased form (e.g. loose and/or water) from the normal, lasting for less than 14 days; persistent diarrhea is defined as three or more stools per day of decreased form from the normal, lasting for more than 14 days but less than 1 month; and chronic diarrhea is defined as three or more stools per day of decreased form from the normal, lasting for a month or more. Associated symptoms of acute diarrhea, persistent diarrhea, and chronic diarrhea may include abdominal cramps or pain, fever, nausea, vomiting, fatigue, urgency, weight loss, and/or malnutrition. Acute diarrhea, persistent diarrhea, and chronic diarrhea are themselves symptoms. Causes of acute diarrhea are well known in the art, and non-limiting examples include a food allergy, antibiotic use, an enteropathogen infection, and radiation therapy. Causes of persistent diarrhea are well known in the art, and non-limiting examples include a food allergy, antibiotic use, an enteropathogen infection, colon resection, colon cancer, ulcerative colitis, necrotizing enterocolitis, Crohn's disease and radiation therapy. Causes of chronic diarrhea are well known in the art, and non-limiting examples include a food allergy, use of a pharmacological agent, an enteropathogen infection, colon resection, colon cancer, ulcerative colitis, necrotizing enterocolitis, Crohn's disease, and radiation therapy. Pharmacological agents known to cause diarrhea are well known in the art and may include, but are not limited to, an antibiotic, an anti-TNF agent, chemotherapy agents, antacids, proton pump inhibitors, (e.g. asomeprazole, esomeprazole, lansoprazole, rabeprazole, patoprazole, cimetidine, ranitidine, naiziatidine), drugs that suppress the immne system (e.g. mycophenolate), antidepressants, blood pressure medications, digitalis, diuretics, cholesterol-lowering agents, lithium, theophylline, thyroid hormone, and colchicine.

In some embodiments, the subject to be treated is a subject with acute diarrhea and a therapeutically effective amount of one or more bacterial taxa of the invention is administered to the subject. Treating acute diarrhea may involve reducing in treated subjects the duration and/or severity of symptoms of acute diarrhea (e.g. fever, bloody stools, vomiting), death rates, or a combination thereof. For each aspect, the amount of reduction may each be about 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, 95% or about 100% in treated subjects, as compared to untreated subjects. Treating an acute diarrhea may also involve reducing in treated subjects the number of stools per day of decreased form by about 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, 95% or about 100% in treated subjects, as compared to untreated subjects. Treating an acute diarrhea may also involve reducing in treated subjects the number of stools per day of decreased form to less than 6, less than 5, less than 4, or less than 3. Treating acute diarrhea may also involve increasing the subject's relative gut microbiota maturity, MAZ score, gut microbiota diversity, or a combination thereof. The duration of treatment can and will vary. In certain embodiments, the duration of therapy is about 1 to about 4 weeks, about 1 to about 3 weeks, about 2 to about 3 weeks, about 1 to about 2 weeks, or about 10 to about 14 days. In other embodiments, the duration of therapy is about 1, 2, 3, or 4 weeks. In still other embodiments, the duration of therapy is about 10, 11, 12, 13, 14, 15, 16, or 17 days. In yet other embodiments, the duration of therapy is about 3, 4, 5, 6, 7, 8, 9, or 10 days. Alternatively, the duration of therapy may be a month or more. Useful combinations are described in further detail in Section III. One or more bacterial taxa of the invention may be formulated for oral or rectal administration, and may be administered alone or with an additional therapeutic agent. Non-limiting examples of additional therapeutic agents include antibiotics, antimotility agents (e.g. loperamide), antisecretory agents (e.g. racecadotril and other agents that reduce the amount of water that is released into the gut during an episode of diarrhea), bulk-forming agents (e.g. isphaghula husk, methylcellulose, sterculia, etc.) prebiotics, probiotics, synbiotics, supplemental zinc therapy, nonsteroidal anti-inflammatory drugs, mucosal protectants and adsorbents (e.g. kaolin-pectin, activated charcoal, bismuth subsalicylate, etc.) and/or rehydration therapy. In exemplary embodiment, acute diarrhea is a symptom of a Vibrio cholerae infection.

In some embodiments, the subject to be treated is a subject with acute diarrhea and a therapeutically effective amount of a bacterial isolate that is a member of the taxon Ruminococcus obeum OTU ID 178122 is administered to the subject, optionally in combination with one or more additional bacterial taxa of the invention. In other embodiments, the subject to be treated is a subject with acute diarrhea and a therapeutically effective amount of Ruminococcus obeum ATCC29714 is administered to the subject, optionally in combination with one or more additional bacterial taxa of the invention. Treating acute diarrhea may involve reducing in treated subjects the duration and/or severity of symptoms of acute diarrhea (e.g. fever, bloody stools, vomiting), death rates, or a combination thereof. For each aspect, the amount of reduction may each be about 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, 95% or about 100% in treated subjects, as compared to untreated subjects. Treating an acute diarrhea may also involve reducing in treated subjects the number of stools per day of decreased form by about 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, 95% or about 100% in treated subjects, as compared to untreated subjects. Treating an acute diarrhea may also involve reducing in treated subjects the number of stools per day of decreased form to less than 6, less than 5, less than 4, or less than 3. Treating acute diarrhea may also involve increasing the subject's relative gut microbiota maturity, MAZ score, gut microbiota diversity, or a combination thereof. The duration of treatment can and will vary. In certain embodiments, the duration of therapy is about 1 to about 4 weeks, about 1 to about 3 weeks, about 2 to about 3 weeks, about 1 to about 2 weeks, or about 10 to about 14 days. In other embodiments, the duration of therapy is about 1, 2, 3, or 4 weeks. In still other embodiments, the duration of therapy is about 10, 11, 12, 13, 14, 15, 16, or 17 days. In yet other embodiments, the duration of therapy is about 3, 4, 5, 6, 7, 8, 9, or 10 days. Alternatively, the duration of therapy may be a month or more. Useful combinations comprising Ruminococcus obeum ATCC29714 or a bacterial isolate that is a member of the taxon Ruminococcus obeum OTU ID 178122 are described in further detail in Section III. A composition comprising Ruminococcus obeum ATCC29714 or a bacterial isolate that is a member of the taxon Ruminococcus obeum OTU ID 178122 may be formulated for oral or rectal administration, and may be administered alone or with an additional therapeutic agent. Non-limiting examples of additional therapeutic agents include antibiotics, antimotility agents (e.g. loperamide), antisecretory agents (e.g. racecadotril and other agents that reduce the amount of water that is released into the gut during an episode of diarrhea), bulk-forming agents (e.g. isphaghula husk, methylcellulose, sterculia, etc.) prebiotics, probiotics, synbiotics, supplemental zinc therapy, nonsteroidal anti-inflammatory drugs, mucosal protectants and adsorbents (e.g. kaolin-pectin, activated charcoal, bismuth subsalicylate, etc.) and/or rehydration therapy. In exemplary embodiment, acute diarrhea is a symptom of a Vibrio cholerae infection.

In some embodiments, the subject to be treated is a subject at risk for acute diarrhea and a therapeutically effective amount of one or more bacterial taxa of the invention is administered to the subject. A subject at risk for acute diarrhea may be a subject living in a geographic area with limited or no access to clean drinking water, a subject living in a geographic area that is experiencing a disease outbreak, or a subject that is exposed to others that have an acute diarrhea. A subject at risk for acute diarrhea may be a subject that is malnourished. Treating a subject at risk for acute diarrhea may prevent acute diarrhea in the subject. For example, preventing an acute diarrhea may involve reducing in treated subjects (1) the incidence, development or formation of the acute diarrhea, (2) the development, duration, and/or severity of symptoms of the acute diarrhea (e.g. fever, bloody stools, vomiting), if the disease does develop, (3) death rates associated with the acute diarrhea, or (4) a combination thereof. For each aspect, the amount of reduction may each be about 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, 95% or about 100% in treated subjects, as compared to untreated subjects. Preventing an acute diarrhea may also involve result in a minimal change in the number of stools per day of decreased form in treated subjects. For example, the change in the number of stools per day of decreased form may be an increase of 3 or less, 2 or less, or 1 or less. Preventing acute diarrhea may also involve increasing the subject's relative gut microbiota maturity, MAZ score, gut microbiota diversity, or a combination thereof. The duration of treatment can and will vary. In certain embodiments, the duration of therapy is about 1 to about 4 weeks, 1 to about 3 weeks, about 2 to about 3 weeks, about 1 to about 2 weeks, or about 10 to about 14 days. In other embodiments, the duration of therapy is about 1, 2, 3, or 4 weeks. In still other embodiments, the duration of therapy is about 10, 11, 12, 13, 14, 15, 16, or 17 days. In yet other embodiments, the duration of therapy is about 3, 4, 5, 6, 7, 8, 9, or 10 days. Alternatively, the duration of therapy may be a month or more. Useful combinations are described in further detail in Section III. One or more bacterial taxa of the invention may be formulated for oral or rectal administration, and may be administered alone or with an additional therapeutic agent. Non-limiting examples of additional therapeutic agents include antibiotics, antimotility agents (e.g. loperamide), antisecretory agents (e.g. racecadotril and other agents that reduce the amount of water that is released into the gut during an episode of diarrhea), bulk-forming agents (e.g. isphaghula husk, methylcellulose, sterculia, etc.) prebiotics, probiotics, synbiotics, supplemental zinc therapy, nonsteroidal anti-inflammatory drugs, mucosal protectants and adsorbents (e.g. kaolin-pectin, activated charcoal, bismuth subsalicylate, etc.) and/or rehydration therapy. In exemplary embodiment, acute diarrhea is a symptom of a Vibrio cholerae infection.

In some embodiments, the subject to be treated is a subject with acute diarrhea and a therapeutically effective amount of a bacterial isolate that is a member of the taxon Ruminococcus obeum OTU ID 178122 is administered to the subject, optionally in combination with one or more additional bacterial taxa of the invention. In some embodiments, the subject to be treated is a subject at risk for acute diarrhea and a therapeutically effective amount of Ruminococcus obeum ATCC29714 is administered to the subject, optionally in combination with one or more additional bacterial taxa of the invention. A subject at risk for acute diarrhea may be a subject living in a geographic area with limited or no access to clean drinking water, a subject living in a geographic area that is experiencing a disease outbreak, or a subject that is exposed to others that have an acute diarrhea. A subject at risk for acute diarrhea may be a subject that is malnourished. Treating a subject at risk for acute diarrhea may prevent acute diarrhea in the subject. For example, preventing an acute diarrhea may involve reducing in treated subjects (1) the incidence, development or formation of the acute diarrhea, (2) the development, duration, and/or severity of symptoms of the acute diarrhea (e.g. fever, bloody stools, vomiting), if the disease does develop, (3) death rates associated with the acute diarrhea, or (4) a combination thereof. For each aspect, the amount of reduction may each be about 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, 95% or about 100% in treated subjects, as compared to untreated subjects. Preventing an acute diarrhea may also involve result in a minimal change in the number of stools per day of decreased form in treated subjects. For example, the change in the number of stools per day of decreased form may be an increase of 3 or less, 2 or less, or 1 or less. Preventing acute diarrhea may also involve increasing the subject's relative gut microbiota maturity, MAZ score, gut microbiota diversity, or a combination thereof. The duration of treatment can and will vary. In certain embodiments, the duration of therapy is about 1 to about 4 weeks, 1 to about 3 weeks, about 2 to about 3 weeks, about 1 to about 2 weeks, or about 10 to about 14 days. In other embodiments, the duration of therapy is about 1, 2, 3, or 4 weeks. In still other embodiments, the duration of therapy is about 10, 11, 12, 13, 14, 15, 16, or 17 days. In yet other embodiments, the duration of therapy is about 3, 4, 5, 6, 7, 8, 9, or 10 days. Alternatively, the duration of therapy may be a month or more. Useful combinations comprising Ruminococcus obeum ATCC29714 or a bacterial isolate that is a member of the taxon Ruminococcus obeum OTU ID 178122 are described in further detail in Section III. A composition comprising Ruminococcus obeum ATCC29714 or a bacterial isolate that is a member of the taxon Ruminococcus obeum OTU ID 178122 may be formulated for oral or rectal administration, and may be administered alone or with an additional therapeutic agent. Non-limiting examples of additional therapeutic agents include antibiotics, antimotility agents (e.g. loperamide), antisecretory agents (e.g. racecadotril and other agents that reduce the amount of water that is released into the gut during an episode of diarrhea), bulk-forming agents (e.g. isphaghula husk, methylcellulose, sterculia, etc.) prebiotics, probiotics, synbiotics, supplemental zinc therapy, nonsteroidal anti-inflammatory drugs, mucosal protectants and adsorbents (e.g. kaolin-pectin, activated charcoal, bismuth subsalicylate, etc.) and/or rehydration therapy. In exemplary embodiment, acute diarrhea is a symptom of a Vibrio cholerae infection.

In some embodiments, the subject to be treated is a subject with chronic diarrhea and a therapeutically effective amount of one or more bacterial taxa of the invention is administered to the subject. Treating chronic diarrhea may involve reducing in treated subjects the duration and/or severity of symptoms of acute diarrhea (e.g. fever, bloody stools, vomiting), death rates, or a combination thereof. For each aspect, the amount of reduction may each be about 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, 95% or about 100% in treated subjects, as compared to untreated subjects. Treating an chronic diarrhea may also involve reducing in treated subjects the number of stools per day of decreased form by about 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, 95% or about 100% in treated subjects, as compared to untreated subjects. Treating an chronic diarrhea may also involve reducing in treated subjects the number of stools per day of decreased form to less than 6, less than 5, less than 4, or less than 3. Treating acute diarrhea may also involve increasing the subject's relative gut microbiota maturity, MAZ score, gut microbiota diversity, or a combination thereof. The duration of treatment can and will vary. In certain embodiments, the duration of therapy is about 1 to about 4 weeks, about 1 to about 3 weeks, about 2 to about 3 weeks, about 1 to about 2 weeks, or about 10 to about 14 days. In other embodiments, the duration of therapy is about 1, 2, 3, or 4 weeks. In still other embodiments, the duration of therapy is about 10, 11, 12, 13, 14, 15, 16, or 17 days. In yet other embodiments, the duration of therapy is about 3, 4, 5, 6, 7, 8, 9, or 10 days. Alternatively, the duration of therapy may be a month or more. Useful combinations are described in further detail in Section III. One or more bacterial taxa of the invention may be formulated for oral or rectal administration, and may be administered alone or with an additional therapeutic agent. Non-limiting examples of additional therapeutic agents include antibiotics, antimotility agents (e.g. loperamide), antisecretory agents (e.g. racecadotril and other agents that reduce the amount of water that is released into the gut during an episode of diarrhea), bulk-forming agents (e.g. isphaghula husk, methylcellulose, sterculia, etc.) prebiotics, probiotics, synbiotics, supplemental zinc therapy, nonsteroidal anti-inflammatory drugs, mucosal protectants and adsorbents (e.g. kaolin-pectin, activated charcoal, bismuth subsalicylate, etc.) and/or rehydration therapy. In exemplary embodiment, chronic diarrhea is a symptom of a C. difficile infection, Crohn's disease, ulcerative colitis, necrotizing enterocolitis, traveler's diarrhea, colon cancer, chemotherapy, radiation therapy, or use of pharmacological agent, including but not limited to an antibiotics, or an anti-TNF agent.

In some embodiments, the subject to be treated is a subject at risk for chronic diarrhea and a therapeutically effective amount of one or more bacterial taxa of the invention is administered to the subject. A subject at risk for chronic diarrhea may be a subject living in a geographic area with limited or no access to clean drinking water, a subject living in a geographic area that is experiencing a disease outbreak, or a subject that is exposed to others that have an acute diarrhea. A subject at risk for chronic diarrhea may be a subject that is malnourished. Treating a subject at risk for chronic diarrhea may prevent acute diarrhea in the subject. For example, preventing an chronic diarrhea may involve reducing in treated subjects (1) the incidence, development or formation of the acute diarrhea, (2) the development, duration, and/or severity of symptoms of the acute diarrhea (e.g. fever, bloody stools, vomiting), if the disease does develop, (3) death rates associated with the acute diarrhea, or (4) a combination thereof. For each aspect, the amount of reduction may each be about 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, 95% or about 100% in treated subjects, as compared to untreated subjects. Preventing an chronic diarrhea may also involve result in a minimal change in the number of stools per day of decreased form in treated subjects. For example, the change in the number of stools per day of decreased form may be an increase of 3 or less, 2 or less, or 1 or less. Preventing chronic diarrhea may also involve increasing the subject's relative gut microbiota maturity, MAZ score, gut microbiota diversity, or a combination thereof. The duration of treatment can and will vary. In certain embodiments, the duration of therapy is about 1 to about 4 weeks, 1 to about 3 weeks, about 2 to about 3 weeks, about 1 to about 2 weeks, or about 10 to about 14 days. In other embodiments, the duration of therapy is about 1, 2, 3, or 4 weeks. In still other embodiments, the duration of therapy is about 10, 11, 12, 13, 14, 15, 16, or 17 days. In yet other embodiments, the duration of therapy is about 3, 4, 5, 6, 7, 8, 9, or 10 days. Alternatively, the duration of therapy may be a month or more. Useful combinations are described in further detail in Section III. One or more bacterial taxa of the invention may be formulated for oral or rectal administration, and may be administered alone or with an additional therapeutic agent. Non-limiting examples of additional therapeutic agents include antibiotics, antimotility agents (e.g. loperamide), antisecretory agents (e.g. racecadotril and other agents that reduce the amount of water that is released into the gut during an episode of diarrhea), bulk-forming agents (e.g. isphaghula husk, methylcellulose, sterculia, etc.) prebiotics, probiotics, synbiotics, supplemental zinc therapy, nonsteroidal anti-inflammatory drugs, mucosal protectants and adsorbents (e.g. kaolin-pectin, activated charcoal, bismuth subsalicylate, etc.) and/or rehydration therapy. In exemplary embodiment, chronic diarrhea is a symptom of a C. difficile infection, Crohn's disease, ulcerative colitis, necrotizing enterocolitis, traveler's diarrhea, colon cancer, radiation therapy, or use of pharmacological agent, including but not limited to an antibiotics, or an anti-TNF agent.

III. Compositions

In an aspect, the present invention provides a composition comprising 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, or 60 bacterial taxa selected from list provided in Table A, wherein each bacterial taxon present in the composition is isolated and biologically pure (i.e. ≥97% sequence identity to the SEQ ID NO. provided).

In another aspect, the present invention provides a combination comprising 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, or 24 bacterial taxa selected from the bacterial taxa listed in Table B, wherein each bacterial taxon present in the composition is isolated and biologically pure (i.e. ≥97% sequence identity to the SEQ ID NO. provided).

In another aspect, the present invention provides a combination comprising 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, or 36 bacterial taxa selected from the bacterial taxa listed in Table C, wherein each bacterial taxon present in the composition is isolated and biologically pure (i.e. ≥97% sequence identity to the SEQ ID NO. provided).

In another aspect, the present invention provides a combination identified below in Table D, wherein each bacterial taxon present in the composition is isolated and biologically pure (i.e. ≥97% sequence identity to the SEQ ID NO. provided).

TABLE D BACTERIAL TAXON 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 A x x B x x x C x x x x D x x x x x E x x x x x x F x x x x x x x G x x x x x x x x H x x x x x x x x x I x x x x x x x x x x J x x x x x x x x x x x K x x x x x x x x x x x x L x x x x x x x x x x x x x M x x x x x x x x x x x x x x N x x x x x x x x x x x x x x x O x x x x x x x x x x x x x x x x P x x x x x x x x x x x x x x x x x Q x x x x x x x x x x x x x x x x x x R x x x x x x x x x x x x x x x x x x x S x x x x x x x x x x x x x x x x x x x x T x x x x x x x x x x x x x x x x x x x x x U x x x x x x x x x x x x x x x x x x x x x x V x x x x x x x x x x x x x x x x x x x x x x x W x x x x x x x x x x x x x x x x x x x x x x x x X x x Y x x x Z x x x x AA x x x x x AB x x x x x x AC x x x x x x x AD x x x x x x x x AE x x x x x x x x x AF x x x x x x x x x x AG x x x x x x x x x x x AH x x x x x x x x x x x x AI x x x x x x x x x x x x x AJ x x x x x x x x x x x x x x AK x x x x x x x x x x x x x x x AL x x x x x x x x x x x x x x x x AM x x x x x x x x x x x x x x x x x AN x x x x x x x x x x x x x x x x x x AO x x x x x x x x x x x x x x x x x x x AP x x x x x x x x x x x x x x x x x x x x AQ x x x x x x x x x x x x x x x x x x x x x AR x x x x x x x x x x x x x x x x x x x x x x AS x x x x x x x x x x x x x x x x x x x x x x x AT x x AU x x x AV x x x x AW x x x x x AX x x x x x x AY x x x x x x x AZ x x x x x x x x AI x x x x x x x x x AJ x x x x x x x x x x AK x x x x x x x x x x x AL x x x x x x x x x x x x AM x x x x x x x x x x x x x AN x x x x x x x x x x x x x x AO x x x x x x x x x x x x x x x AP x x x x x x x x x x x x x x x x AQ x x x x x x x x x x x x x x x x x AR x x x x x x x x x x x x x x x x x x AS x x x x x x x x x x x x x x x x x x x AT x x x x x x x x x x x x x x x x x x x x AU x x x x x x x x x x x x x x x x x x x x x AV x x x x x x x x x x x x x x x x x x x x x x AW x x x x x x x x x x x x x x x x x x x x x x x AX x x AY x x x AZ x x x x BA x x x x x BB x x x x x x BC x x x x x x x BD x x x x x x x x BE x x x x x x x x x BF x x x x x x x x x x BG x x x x x x x x x x x BH x x x x x x x x x x x x BI x x x x x x x x x x x x x BJ x x x x x x x x x x x x x x BK x x x x x x x x x x x x x x x BL x x x x x x x x x x x x x x x x BM x x x x x x x x x x x x x x x x x BN x x x x x x x x x x x x x x x x x x BO x x x x x x x x x x x x x x x x x x x BP x x x x x x x x x x x x x x x x x x x x BQ x x x x x x x x x x x x x x x x x x x x x BR x x BS x x x BT x x x x BU x x x x x BV x x x x x x BW x x x x x x x BX x x x x x x x x BY x x x x x x x x x BZ x x x x x x x x x x CA x x x x x x x x x x x CB x x x x x x x x x x x x CC x x x x x x x x x x x x x CD x x x x x x x x x x x x x x CE x x x x x x x x x x x x x x x CF x x x x x x x x x x x x x x x x CG x x x x x x x x x x x x x x x x x CH x x x x x x x x x x x x x x x x x x CI x x x x x x x x x x x x x x x x x x x CJ x x x x x x x x x x x x x x x x x x x x CK x x x x x x x x x x x x x x x x x x x x x CL x x x x x x x x x x x x x x x x x x x x x x CM x x x x x x x x x x x x x x x x x x x x x x x CN x x CO x x x CP x x x x CQ x x x x x CR x x x x x x CS x x x x x x x CT x x x x x x x x CU x x x x x x x x x CV x x x x x x x x x x CW x x x x x x x x x x x CX x x x x x x x x x x x x CY x x x x x x x x x x x x x CZ x x x x x x x x x x x x x x DA x x x x x x x x x x x x x x x DB x x x x x x x x x x x x x x x x DC x x x x x x x x x x x x x x x x x DD x x x x x x x x x x x x x x x x x x DE x x x x x x x x x x x x x x x x x x x DF x x x x x x x x x x x x x x x x x x x x DG x x x x x x x x x x x x x x x x x x x x x DH x x x x x x x x x x x x x x x x x x x x x x DI x x x x x x x x x x x x x x x x x x x x x x x DJ x x DK x x x DL x x x x DM x x x x x DN x x x x x x DO x x x x x x x DP x x x x x x x x DQ x x x x x x x x x DR x x x x x x x x x x DS x x x x x x x x x x x DT x x x x x x x x x x x x DU x x x x x x x x x x x x x DV x x x x x x x x x x x x x x DW x x x x x x x x x x x x x x x DX x x x x x x x x x x x x x x x x DY x x x x x x x x x x x x x x x x x DZ x x x x x x x x x x x x x x x x x x EA x x x x x x x x x x x x x x x x x x x EB x x x x x x x x x x x x x x x x x x x x EC x x x x x x x x x x x x x x x x x x x x x ED x x x x x x x x x x x x x x x x x x x x x x EE x x x x x x x EF x x x EG x x x x EH x x x x x EI x x x x x x EJ x x x x x x x EK x x x x x x x x EL x x x x x x x x x EM x x x x x x x x x x EN x x x x x x x x x x x EO x x x x x x x x x x x x EP x x x x x x x x x x x x x EQ x x x x x x x x x x x x x x ER x x x x x x x x x x x x x x x ES x x x x x x x x x x x x x x x x ET x x x x x x x x x x x x x x x x x EU x x x x x x x x x x x x x x x x x x EV x x x x x x x x x x x x x x x x x x x EW x x x x x x x x x x x x x x x x x x x x EX x x x x x x x x x x x x x x x x x x x x x EY x x x x x x x x x x x x x x x x x x x x x x EZ x x x x x x x x x x x x x x x x x x x x x x x FA x x FB x x x FC x x x x FD x x x x x FE x x x x x x FF x x x x x x x FG x x x x x x x x FH x x x x x x x x x FI x x x x x x x x x x FJ x x x x x x x x x x x FK x x x x x x x x x x x x FL x x x x x x x x x x x x x FM x x x x x x x x x x x x x x FN x x x x x x x x x x x x x x x FO x x x x x x x x x x x x x x x x FP x x x x x x x x x x x x x x x x x FQ x x x x x x x x x x x x x x x x x x FR x x x x x x x x x x x x x x x x x x x FS x x x x x x x x x x x x x x x x x x x x FT x x x x x x x x x x x x x x x x x x x x x FU x x x x x x x x x x x x x x x x x x x x x x FV x x x x x x x x x x x x x x x x x x x x x x x FW x x FX x x x FY x x x x FZ x x x x x GA x x x x x x GB x x x x x x x GC x x x x x x x x GD x x x x x x x x x GE x x x x x x x x x x GF x x x x x x x x x x x GG x x x x x x x x x x x x GH x x x x x x x x x x x x x GI x x x x x x x x x x x x x x GJ x x x x x x x x x x x x x x x GK x x x x x x x x x x x x x x x x GL x x x x x x x x x x x x x x x x x GM x x x x x x x x x x x x x x x x x x GN x x x x x x x x x x x x x x x x x x x GO x x x x x x x x x x x x x x x x x x x x GP x x x x x x x x x x x x x x x x x x x x x GQ x x x x x x x x x x x x x x x x x x x x x x GR x x x x x x x x x x x x x x x x x x x x x x x GR x x GS x x x GT x x x x GU x x x x x GV x x x x x x GW x x x x x x x GX x x x x x x x x GY x x x x x x x x x GZ x x x x x x x x x x HA x x x x x x x x x x x HB x x x x x x x x x x x x HC x x x x x x x x x x x x x HD x x x x x x x x x x x x x x HE x x x x x x x x x x x x x x x HF x x x x x x x x x x x x x x x x HG x x x x x x x x x x x x x x x x x HH x x x x x x x x x x x x x x x x x x HI x x x x x x x x x x x x x x x x x x x HJ x x x x x x x x x x x x x x x x x x x x HK x x x x x x x x x x x x x x x x x x x x HL x x x x x x x x x x x x x x x x x x x x x x HM x x x x x x x x x x x x x x x x x x x x x x x HN x x HO x x x HP x x x x HQ x x x x x HR x x x x x x HS x x x x x x x HT x x x x x x x x HU x x x x x x x x x HV x x x x x x x x x x HW x x x x x x x x x x x HX x x x x x x x x x x x x HY x x x x x x x x x x x x x HZ x x x x x x x x x x x x x x IA x x x x x x x x x x x x x x x IB x x x x x x x x x x x x x x x x IC x x x x x x x x x x x x x x x x x ID x x x x x x x x x x x x x x x x x x IE x x x x x x x x x x x x x x x x x x x IF x x x x x x x x x x x x x x x x x x x x IG x x x x x x x x x x x x x x x x x x x x x IH x x x x x x x x x x x x x x x x x x x x x x II x x x x x x x x x x x x x x x x x x x x x x x IJ x x IK x x x IL x x x x IM x x x x x IN x x x x x x IO x x x x x x x IP x x x x x x x x IQ x x x x x x x x x IR x x x x x x x x x x IS x x x x x x x x x x x IT x x x x x x x x x x x x IU x x x x x x x x x x x x x IV x x x x x x x x x x x x x x IC x x x x x x x x x x x x x x x ID x x x x x x x x x x x x x x x x IE x x x x x x x x x x x x x x x x x IF x x x x x x x x x x x x x x x x x x IG x x x x x x x x x x x x x x x x x x x IH x x x x x x x x x x x x x x x x x x x x II x x x x x x x x x x x x x x x x x x x x x IJ x x x x x x x x x x x x x x x x x x x x x x IK x x x x x x x x x x x x x x x x x x x x x x x IL x x IM x x x IN x x x x IO x x x x x IP x x x x x x IQ x x x x x x x IR x x x x x x x x IS x x x x x x x x x IT x x x x x x x x x x IU x x x x x x x x x x x IV x x x x x x x x x x x x IW x x x x x x x x x x x x x IX x x x x x x x x x x x x x x IY x x x x x x x x x x x x x x x IZ x x x x x x x x x x x x x x x x JA x x x x x x x x x x x x x x x x x JB x x x x x x x x x x x x x x x x x x JC x x x x x x x x x x x x x x x x x x x JD x x x x x x x x x x x x x x x x x x x x JE x x x x x x x x x x x x x x x x x x x x x JF x x x x x x x x x x x x x x x x x x x x x x JK x x x x x x x x x x x x x x x x x x x x x x x JL x x JM x x x JN x x x x JO x x x x x JP x x x x x x JQ x x x x x x x JR x x x x x x x x JS x x x x x x x x x JT x x x x x x x x x x JU x x x x x x x x x x x JV x x x x x x x x x x x x JW x x x x x x x x x x x x x JX x x x x x x x x x x x x x x JY x x x x x x x x x x x x x x x JZ x x x x x x x x x x x x x x x x KA x x x x x x x x x x x x x x x x x KB x x x x x x x x x x x x x x x x x x KC x x x x x x x x x x x x x x x x x x x KD x x x x x x x x x x x x x x x x x x x x KE x x x x x x x x x x x x x x x x x x x x x KF x x x x x x x x x x x x x x x x x x x x x x KG x x x x x x x x x x x x x x x x x x x x x x x KH x x KI x x x KJ x x x x KK x x x x x KL x x x x x x KM x x x x x x x KN x x x x x x x x KO x x x x x x x x x KP x x x x x x x x x x KQ x x x x x x x x x x x KR x x x x x x x x x x x x KS x x x x x x x x x x x x x KT x x x x x x x x x x x x x x KU x x x x x x x x x x x x x x x KV x x x x x x x x x x x x x x x x KW x x x x x x x x x x x x x x x x x KX x x x x x x x x x x x x x x x x x x KY x x x x x x x x x x x x x x x x x x x KZ x x x x x x x x x x x x x x x x x x x x LA x x x x x x x x x x x x x x x x x x x x x LB x x x x x x x x x x x x x x x x x x x x x x LC x x x x x x x x x x x x x x x x x x x x x x x LD x x LE x x x LF x x x x LG x x x x x LH x x x x x x LI x x x x x x x LJ x x x x x x x x LK x x x x x x x x x LL x x x x x x x x x x LM x x x x x x x x x x x LN x x x x x x x x x x x x LO x x x x x x x x x x x x x LP x x x x x x x x x x x x x x LQ x x x x x x x x x x x x x x x LR x x x x x x x x x x x x x x x x LS x x x x x x x x x x x x x x x x x LT x x x x x x x x x x x x x x x x x x LU x x x x x x x x x x x x x x x x x x x LV x x x x x x x x x x x x x x x x x x x x LW x x x x x x x x x x x x x x x x x x x x x LX x x x x x x x x x x x x x x x x x x x x x x LY x x x x x x x x x x x x x x x x x x x x x x x LZ x x MA x x x MB x x x x MC x x x x x MD x x x x x x ME x x x x x x x MF x x x x x x x x MG x x x x x x x x x MH x x x x x x x x x x MI x x x x x x x x x x x MJ x x x x x x x x x x x x MK x x x x x x x x x x x x x ML x x x x x x x x x x x x x x MM x x x x x x x x x x x x x x x MN x x x x x x x x x x x x x x x x MO x x x x x x x x x x x x x x x x x MP x x x x x x x x x x x x x x x x x x MQ x x x x x x x x x x x x x x x x x x x MR x x x x x x x x x x x x x x x x x x x x MS x x x x x x x x x x x x x x x x x x x x x MT x x x x x x x x x x x x x x x x x x x x x x MU x x x x x x x x x x x x x x x x x x x x x x x MV x x MW x x x MX x x x x MY x x x x x MZ x x x x x x NA x x x x x x x NB x x x x x x x x NC x x x x x x x x x ND x x x x x x x x x x NE x x x x x x x x x x x NF x x x x x x x x x x x x NG x x x x x x x x x x x x x NH x x x x x x x x x x x x x x NI x x x x x x x x x x x x x x x NJ x x x x x x x x x x x x x x x x NK x x x x x x x x x x x x x x x x x NL x x x x x x x x x x x x x x x x x x NM x x x x x x x x x x x x x x x x x x x NN x x x x x x x x x x x x x x x x x x x x NO x x x x x x x x x x x x x x x x x x x x x NP x x x x x x x x x x x x x x x x x x x x x x NQ x x x x x x x x x x x x x x x x x x x x x x x NR x x NS x x x NT x x x x NU x x x x x NV x x x x x x NW x x x x x x x NX x x x x x x x x NY x x x x x x x x x NZ x x x x x x x x x x OA x x x x x x x x x x x OB x x x x x x x x x x x x OC x x x x x x x x x x x x x OD x x x x x x x x x x x x x x OE x x x x x x x x x x x x x x x OF x x x x x x x x x x x x x x x x OG x x x x x x x x x x x x x x x x x OH x x x x x x x x x x x x x x x x x x OI x x x x x x x x x x x x x x x x x x x OJ x x x x x x x x x x x x x x x x x x x x OK x x x x x x x x x x x x x x x x x x x x x OL x x x x x x x x x x x x x x x x x x x x x x OM x x x x x x x x x x x x x x x x x x x x x x x ON x x OO x x x x OP x x x x x OQ x x x x x x OR x x x x x x x OS x x x x x x x x OT x x x x x x x x x OU x x x x x x x x x x OV x x x x x x x x x x x OW x x x x x x x x x x x x OX x x x x x x x x x x x x x OY x x x x x x x x x x x x x x OZ x x x x x x x x x x x x x x x PA x x x x x x x x x x x x x x x x PB x x x x x x x x x x x x x x x x x PC x x x x x x x x x x x x x x x x x x PD x x x x x x x x x x x x x x x x x x x PE x x x x x x x x x x x x x x x x x x x x PF x x x x x x x x x x x x x x x x x x x x x PG x x x x x x x x x x x x x x x x x x x x x x PH x x x x x x x x x x x x x x x x x x x x x x x PI x x PJ x x x PK x x PL x x PM x x x PN x x x x PO x x x x x PP x x x x x x PQ x x x x x x x PR x x x x x x x x PS x x x x x x x x x PT x x x x x x x x x x PU x x x x x x x x x x x PV x x x x x x x x x x x x PW x x x x x x x x x x x x x PX x x x x x x x x x x x x x x PY x x x x x x x x x x x x x x x PZ x x x x x x x x x x x x x x x x QA x x x x x x x x x x x x x x x x x QB x x x x x x x x x x x x x x x x x x QC x x x x x x x x x x x x x x x x x x x QD x x x x x x x x x x x x x x x x x x x x QE x x x x x x x x x x x x x x x x x x x x x QF x x x x x x x x x x x x x x x x x x x x x x QG x x x x x x x x x x x x x x x x x x x x x x x Strain 1: Faecalibacterium prausnitzii OTU ID 326792, Strain 2: Ruminococcus sp. 5 1 39BFAA OTU ID 189827, Strain 3: Lactobacillus ruminis OTU ID 470663, Strain 4: Dorea longicatena OTU ID 191687, Strain 5: Bifidobacterium longum OTU ID 72820, Strain 6: Ruminococcus sp. 5 1 39BFAA OTU ID 194745, Strain 7: Lactobacillus mucosae OTU ID 15141, Strain 8: Bifidobacterium sp. OTU ID 561483, Strain 9: Staphylococcus sp. OTU ID 217996, Strain 10: Ruminococcus sp. 5 1 39BFAA OTU ID 364234, Strain 11: Catenibacterium mitsuokai OTU ID 287510, Strain 12: Dorea formicigenerans OTU ID 261912, Strain 13: Ruminococcus torques OTU ID 361809, Strain 14: Streptococcus thermophilus OTU ID 108747, Strain 15: Bifidobacterium sp. OTU ID 533785, Strain 16: Haemophilus parainfluenzae OTU ID 9514, Strain 17: Streptococcus sp. OTU ID 561636, Strain 18: Clostridium sp. OTU ID 312461, Strain 19: Clostridium ramosum OTU ID 470139, Strain 20: Clostridium sp. OTU ID 181834, Strain 21: Weissella cibaria OTU ID 148099, Strain 22: Bifidobacterium sp. OTU ID 469873, Strain 23: Clostridiales sp. OTU ID 185951, Strain 24: Ruminococcaceae sp. OTU ID 212619. Additional information about these bacterial taxa may be found in Table B.

A bacterial taxon of the invention, or a combination of bacterial taxa of the invention, is formulated to maintain a suitable level of viable cells during the formulation's shelf life and upon administration to a subject. Each bacterial taxon may be present in a wide range of amounts provided that the composition or combination delivers the effect described. The total amount of bacteria per unit dose is dependent, in part, upon the dosage form and excipients. Non-limiting examples of suitable amounts include from about 10² to about 10¹² colony forming units (cfu) of each bacterial strain per unit dose. In some embodiments, the amount of each bacterial strain is between about 10⁵ and about 10¹² cfu per unit dose, between about 10⁶ and about 10¹² cfu per unit dose, between about 10⁷ and about 10¹² cfu per unit dose, or between about 10⁸ and about 10¹² cfu per unit dose. In other embodiments, the amount of each bacterial strain is between about 10⁵ and about 10¹¹ cfu per unit dose, between about 106 and about 10¹¹ cfu per unit dose, between about 10⁷ and about 10¹¹ cfu per unit dose, or between about 108 and about 10¹¹ cfu per unit dose. In other embodiments, the amount of each bacterial strain is between about 10⁵ and about 10¹⁰ cfu per unit dose, between about 106 and about 10¹⁰ cfu per unit dose, between about 10⁷ and about 10¹⁰ cfu per unit dose, or between about 10⁸ and about 10¹⁰ cfu per unit dose. In other embodiments, the amount of each bacterial taxon is between about 10⁵ and about 10⁹ cfu per unit dose, between about 10⁶ and about 10⁹ cfu per unit dose, between about 10⁷ and about 10⁹ cfu per unit dose, or between about 10⁸ and about 10⁹ cfu per unit dose. Generally, a bacterial strain may be provided as a frozen or freeze-dried culture, or as bacterial spores.

A bacterial taxon of the invention, or a combination of bacterial taxa of the invention, may be formulated into a formulation for oral or rectal administration comprising one or more bacterial taxa of the invention and one more excipients. Non-limiting examples of excipients include binders, diluents, fillers, disintegrants, effervescent disintegration agents, preservatives, antioxidants, flavor-modifying agents, lubricants and glidants, dispersants, coloring agents, pH modifiers, chelating agents, and release-controlling polymers. Bacterial taxa of the invention, or a combination of bacterial taxa of the invention, may be formulated in unit dosage form as a solid, semi-solid, liquid, capsule, or powder. These formulations are a further aspect of the invention. Usually the amount of a bacterial taxon of the invention, or a combination of bacterial taxa of the invention, is between 0.1-95% by weight of the formulation, or between 1 and 50% by weight of the formulation. Methods of formulating compositions are discussed in, for example, Hoover, John E., Remington's Pharmaceutical Sciences, Mack Publishing Co., Easton, Pa. (1975), and Liberman, H. A. and Lachman, L., Eds., Pharmaceutical Dosage Forms, Marcel Decker, New York, N.Y. (1980).

In the preparation of formulations in dosage units for oral administration, a bacterial taxon of the invention, or a combination of bacterial taxa of the invention, may be mixed with a solid, powdered carrier, e.g. lactose, saccharose, sorbitol, mannitol, starch, amylopectin, cellulose derivatives or gelatin, and optionally with lubricants (e.g. magnesium stearate, calcium stearate, sodium steryl fumarate and polyethylene glycol waxes), release-controlling polymers and other excipients. The mixture is then processed into granules or pressed into tablets. Since the viability of the a bacterial strain may be negatively impacted by acidic media, the above-mentioned granules or tablets may be coated with an enteric coating which protects the combination of the invention from acid degradation as long as the dosage form remains in the stomach. The enteric coating is chosen among pharmaceutically acceptable enteric-coating materials e.g. beeswax, shellac or anionic film-forming polymers such as cellulose acetate phthalate, hydroxypropyl methylcellulose phthalate, partly methyl esterified methacrylic acid polymers and the like, if preferred in combination with a suitable plasticizer. To this coating various dyes may be added in order to distinguish among tablets or granules with different combinations or with different amounts of the combination present.

Alternatively, the pharmaceutical compositions may be incorporated into a food product or powder for mixing with a liquid, or administered orally after only mixing with a non-foodstuff liquid.

Soft gelatine capsules may also be prepared with capsules comprising a combination of the invention and vegetable oil, fat, or other suitable vehicle for soft gelatine capsules. Soft gelatine capsules are preferably enteric coated as described above. Hard gelatine capsules may contain enteric-coated granules of a combination of the invention. Hard gelatine capsules may also contain a combination of the invention in combination with a solid powdered carrier e.g. lactose, saccharose, sorbitol, mannitol, potato starch, corn starch, amylopectin, cellulose derivatives or gelatine; the hard gelatine capsules are preferably enteric coated as described above.

Dosage units for rectal administration may be prepared in the form of suppositories which comprise a bacterial taxon of the invention, or a combination of bacterial taxa of the invention, mixed with a non-irritating excipient that is solid at room temperature but liquid at rectal temperature and therefore will melt in the rectum to release the drug. Non-limiting examples of suitable excipients for rectal suppository embodiments include cocoa butter, beeswax, and polyethylene glycols. Alternatively, a dosage unit for rectal administration may be prepared in the form of a gelatine rectal capsule which comprises a bacterial taxon of the invention, or a combination of bacterial taxa of the invention, in a mixture with a vegetable oil, paraffin oil or other suitable vehicle for gelatine rectal capsules. In yet another alternative, a bacterial taxon of the invention, or a combination of bacterial taxa of the invention, may be prepared in the form of a ready-made enema, or in the form of a dry enema formulation to be reconstituted in a suitable solvent just prior to administration.

Liquid preparations for oral administration may be prepared in the form of syrups or suspensions, e.g. solutions or suspensions containing from 0.2% to 20% by weight of a bacterial taxon of the invention, or a combination of bacterial taxa of the invention, and the remainder consisting of sugar or sugar alcohols and a mixture of ethanol, water, glycerol, propylene glycol and polyethylene glycol. If desired, such liquid preparations may contain colouring agents, flavouring agents, saccharine and carboxymethyl cellulose and thickening agent. Liquid preparations for oral administration may also be prepared in the form of a dry powder to be reconstituted with a suitable solvent prior to use.

The dosing regimen involving compositions in accordance with the present disclosure can be varied to achieve a desired result, such as may be determined empirically for a given individual subject, or by extrapolation from data obtained from administering a composition of the invention to a clinical or other test population. The desired dose may be presented in multiple (e.g., two, three, four, five, six, or more) sub-doses administered at appropriate intervals throughout the day.

The following examples are included to demonstrate preferred embodiments of the invention. It should be appreciated by those of skill in the art that the techniques disclosed in the examples that follow represent techniques discovered by the inventors to function well in the practice of the invention. Those of skill in the art should, however, in light of the present disclosure, appreciate that changes may be made in the specific embodiments that are disclosed and still obtain a like or similar result without departing from the spirit and scope of the invention. Therefore, all matter set forth or shown in the accompanying drawings is to be interpreted as illustrative and not in a limiting sense.

EXAMPLES

The following examples illustrate various iterations of the invention.

Severe acute malnutrition and moderate acute malnutrition (MAM) are typically defined by anthropometric measurements: children are classified as having SAM if their weight-for-height Z-scores (WHZ)³ are below three standard deviations (—3 s.d.) from the median of the World Health Organization (WHO) reference growth standards, whereas those with WHZ between—2 and—3 s.d. are categorized as having MAM. SAM and MAM typically develop between 3 and 24 months after birth⁴. A standardized treatment protocol for SAM and its complications has been developed in Bangladesh¹. The result has been a reduction in mortality rate, although the extent to which this protocol results in long-term restoration of normal growth and development needs to be ascertained through longitudinal studies^(5,6). There is similar lack of clarity about the long-term efficacy of nutritional interventions for MAM^(7,8).

Food is a major factor that shapes the proportional representation of organisms present in the gut microbial community (microbiota), and its gene content (microbiome). The microbiota and microbiome in turn have an important role in extracting and metabolizing dietary ingredients⁹⁻¹⁴. To investigate the hypothesis that healthy postnatal development (maturation) of the gut microbiota is perturbed in malnutrition¹², we monitored 50 healthy Bangladeshi children monthly during the first 2 years after birth (25 singletons, 11 twin pairs, 1 set of triplets; 996 faecal samples collected monthly; see Methods for Examples 1-9 and Tables 1 and 2). By identifying bacterial taxa that discriminate the microbiota of healthy children at different chronologic ages, we were able to test our hypothesis by studying 6 to 20-month-old children presenting with SAM, just before, during, and after treatment with two very different types of food intervention, as well as children with MAM. The results provide a different perspective about malnutrition; one involving disruption of a microbial facet of our normal human postnatal development.

To characterize gut microbiota maturation across unrelated healthy Bangladeshi children living in separate households, faecal samples were collected at monthly intervals up to 23.4±0.5 months of age in a training set of 12 children who exhibited consistently healthy anthropometric scores (WHZ, —0.32±0.98 (mean±s.d.) 22.7±1.5 faecal samples per child; Table 3a). The bacterial component of their faecal microbiota samples was characterized by V4-16S rRNA sequencing (Table 4) and assigning the resulting reads to operational taxonomic units (OTUs) sharing 97% nucleotide sequence identity (see Methods for Examples 1-9; a 97%-identity OTU is commonly construed as representing a species-level taxon). The relative abundances of 1,222 97%-identity OTUs that passed our filtering criterion¹⁵ were regressed against the chronologic age of each child at the time of faecal sample collection using the Random Forests machine learning algorithm¹⁶. The regression explained 73% of the variance related to chronologic age. The significance of the fit was established by comparing fitted to null models in which age labels of samples were randomly permuted with respect to their 16S rRNA microbiota profiles (P=0.0001, 9,999 permutations). Ranked lists of all bacterial taxa, in order of ‘age-discriminatory importance’, were determined by considering those taxa, whose relative abundance values when permuted have a larger marginal increase in mean squared error, to be more important (see Methods for Examples 1-9). Tenfold cross-validation was used to estimate age-discriminatory performance as a function of the number of top-ranking taxa according to their feature importance scores. Minimal improvement in predictive performance was observed when including taxa beyond the top 24 (see Table 5 for the top 60). The 24 most age-discriminatory taxa identified by Random Forests are shown in FIG. 1A in rank order of their contribution to the predictive accuracy of the model and were selected as inputs to a sparse 24-taxon model.

To test the extent to which this sparse model could be applied, we applied it, with no further parameter optimization, to additional monthly faecal samples collected from two other healthy groups of children: 13 singletons (WHZ, —0.4±0.8 (mean±s.d.)) and 25 children from a birth-cohort study of twins and triplets, (WHZ, —0.5±0.7 (mean±s.d.)), all born and raised in Mirpur, Bangladesh (Table 3b,c). We found that the model could be applied to both groups (r²=0.71 and 0.68, respectively), supporting the consistency of the observed taxonomic signature of microbiota maturation across different healthy children living in this geographic locale (FIGS. 1B-D and F-H).

Two metrics of microbiota maturation were defined by applying the sparse model to the 13 healthy singletons and 25 members of twin pairs and triplets that had been used for model validation. The first metric, relative microbiota maturity, was calculated as follows: relative microbiota maturity=(microbiota age of child)−(microbiota age of healthy children of similar chronologic age) where microbiota age values for healthy children were interpolated across the first 2 years of life using a spline fit (FIG. 1B-D). The second metric, microbiota-for-age Z score, was calculated as follows: MAZ=(microbiota age−median microbiota age of healthy children of same chronologic age)

(s.d. of microbiota age of healthy children of the same chronologic age) where MAZ is the microbiota-for-age Z-score, and median and s.d. of microbiota age were computed for each month up to 24 months. The MAZ accounts for the variance of predictions of microbiota age as a function of different host age ranges (when considered in discrete monthly bins) (see FIG. 3 for the calculation of each metric, and Example 8 for discussion of how this approach defines immaturity as a specific recognizable state rather than as a lack of maturity).

To study the influences of genetic and environmental factors on these microbiota maturation indices, we examined their distribution in healthy Bangladeshi twins and triplets. Monozygotic twins were not significantly more correlated in their maturity profiles compared to dizygotic twins, and within the set of triplets, the two monozygotic siblings were not more correlated than their fraternal sibling (monozygotic pairs, 0.1±0.5 (Spear-man's Rho±s.d.); dizygotic pairs, 0.33±0.3; in the case of the triplets, values for the monozygotic pair and fraternal sibling were 0.1; and 0.24±0.3, respectively). Maturity was significantly decreased in faecal samples obtained during and 1 month after diarrhoeal episodes (P<0.001 and P<0.01, respectively) but not beyond that period (FIG. 4). There was no discernible effect of recent antibiotic usage (1 week before sampling) on relative microbiota maturity, whereas intake of infant formula was associated with significantly higher maturity values (Table 6). Family membership explained 29% of the total variance in relative microbiota maturity measurements (log-likelihood ratio=102.1,P<0.0001; linear mixed model) (see Example 3, Tables 7 and 8, and FIG. 5 for analyses of faecal microbiota variation in mother-infant dyads and fathers).

To investigate the effects of SAM on microbiota maturity, 64 children with SAM who had been admitted to the Nutritional Rehabilitation Unit of the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka Hospital, were enrolled in a study to investigate the configuration of their faecal microbiota before, during and after treatment with either an imported, internationally used ready-to-use therapeutic food (RUTF; Plumpy'Nut) or a locally produced, lower-cost nutritional food combination (Khichuri-Halwa). Children ranged in age from 6 to 20 months of age at the time of enrollment and were randomly assigned to either of the treatment arms. At enrollment, WHZ averaged—4.2±0.7 (mean±s.d.) (see Tables 9 and 10 for patient metadata and FIG. 2A for study design). In the initial ‘acute phase’ of treatment, infection control was achieved with parenteral administration of ampicillin and gentamicin for 2 and 7 days, respectively, and oral amoxicillin for 5 days (from days 3 to 7 of the antibiotic treatment protocol). Children with SAM were initially stabilized by being fed the milk-based gruel, ‘suji’, followed by randomization to either an imported peanut-based RUTF intervention or an intervention with locally produced, rice-and-lentil-based therapeutic foods (Khichuri and Halwa; see Methods for Examples 1-9 and Table 11 for compositions of all foods used during nutritional rehabilitation). During this second ‘nutritional rehabilitation phase’ (1.3±0.7 weeks long) children received 150-250 kcal kg⁻¹ body weight per day of RUTF or Khichuri-Halwa (3-5 g protein kg⁻¹ per day), plus micronutrients including iron. Children were discharged from the hospital after the completion of this second phase; during the ‘post-intervention phase’, periodic follow-up examinations were performed to monitor health status. Faecal samples were obtained during the acute phase before treatment with Khichuri-Halwa or RUTF, then every 3 days during the nutritional rehabilitation phase, and monthly thereafter during the post-intervention follow-up period.

There was no significant difference in the rate of weight gain between the RUTF and Khichuri-Halwa groups (10.9±4.6 versus 10.4±5.4 g kg⁻¹ body weight per day (mean±s.d.); Student's t-test, P=0.7). The mean WHZ at the completion of nutritional rehabilitation was significantly improved in both treatment groups (−3.1±0.7(mean±s.d.) RUTF, P<0.001; and −2.7±1.6 Khichuri-Halwa, P<0.0001), but not significantly different between groups (P=0.15). During follow-up, WHZ remained significantly lower compared to healthy children (−2.1±1.2, Khichuri-Halwa; −2.4±0.8 RUTF versus −0.5±1.1 for healthy, P<0.0001; FIG. 6A). Children in both treatment arms also remained markedly below normal height and severely underweight throughout the follow-up period (FIG. 6B,C).

The Random Forests model derived from healthy children was used to define relative microbiota maturity for children with SAM at the time of enrollment, during treatment, at the end of either nutritional intervention, and during the months of follow-up. The results revealed that compared to healthy children, children with SAM had significant microbiota immaturity at the time that nutritional rehabilitation was initiated and at cessation of treatment (Dunnett's post-hoc test, P<0.0001 for both groups; FIG. 2B). Within 1 month of follow-up, both groups had improved significantly. However, improvement in this metric was short-lived for the RUTF and Khichuri-Halwa groups, with regression to significant immaturity relative to healthy children beyond 4 months after treatment was stopped (FIG. 2B and Table 12). MAZ, like relative microbiota maturity, indicated a transient improvement after RUTF intervention that was not durable beyond 4 months. In the Khichuri-Halwa group, relative microbiota maturity and MAZ improved following treatment, but subsequently regressed, exhibiting significant differences relative to healthy children at 2-3 months, and >4 months after cessation of treatment (FIG. 2B and Table 12).

Both food interventions had non-durable effects on other microbiota parameters. The reduced bacterial diversity associated with SAM persisted after Khichuri-Halwa and only transiently improved with RUTF (FIG. 7 and Table 12). We identified a total of 220 bacterial taxa that were significantly different in their proportional representation in the faecal microbiota of children with SAM compared to healthy children; 165 of these 220 97%-identity OTUs were significantly diminished in the microbiota of children with SAM during the longer term follow-up period in both treatment groups (FIGS. 8 and 9 and Table 13).

Although the majority of children in both treatment arms of the SAM study were unable to provide faecal samples before the initiation of antibiotic treatment due to the severity of the illness, a subset of nine children each provided one or two faecal samples (n=12) before administration of parenteral ampicillin and gentamicin, and oral amoxicillin. Microbiota immaturity was manifest at this early time-point before antibiotics in these nine children (relative microbiota maturity: −5.15±0.9 months versus −0.03±0.1 for the 38 reference healthy controls; Mann-Whitney, P<0.0001). Sampling these nine children after treatment with parenteral and oral antibiotics but before initiation of RUTF or Khichuri-Halwa (6±3.6 days after hospital admission) showed that there was no significant effect on microbiota maturity (Wilcoxon matched-pairs rank test, P=1). When pre-antibiotic faecal samples from these nine children were compared to samples collected at the end of all treatment interventions (dietary and antibiotic, 20±9 days after admission), no significant differences in relative microbiota maturity (Wilcoxon, P=0.7), MAZ, bacterial diversity (or WHZ) were found (FIG. 10A-D). This is not to say that these interventions were without effects on overall community composition: opposing changes in the relative abundance of Streptococcaceae and Enterobacteriaceae were readily apparent (FIG. 10E,F; note that the Random Forests model classified both the microbiota of children with SAM sampled before and at the conclusion of all treatment interventions as immature, indicating lack of a generic immature state). Although these findings indicate that the relative microbiota immaturity associated with SAM was not solely attributable to the antibiotics used to treat these children, we could not, in cases where children were unable to provide pre-intervention faecal samples, measure the effects of other antibiotics, consumed singly or in various combinations during the acute infection control and nutritional rehabilitation phases, on their metrics of microbiota maturation (see Example 7 and Table 14 for further evidence indicating antibiotic use in the follow-up period did not correlate with the persistence of microbiota immaturity in children with SAM).

SAM affects approximately 4% of children in developing countries. MAM is more prevalent, particularly in South Central Asia, where it affects approximately 19% (30 million children)⁷. Epidemiological studies indicate that periods of MAM are associated with progression to SAM, and with stunting which affects >40% of children under the age of five in Bangladesh¹⁷. Therefore, we extended our study to children from the singleton cohort at 18 months of age, when all had transitioned to solid foods (n=10 children with WHZ lower than −2 s.d., the threshold for MAM; 23 children with healthy WHZ; Table 15). The relationship between relative microbiota maturity, MAZ and WHZ was significant (Spearman's Rho=0.62 and 0.63, P<0.001, respectively; FIG. 11A,B). Comparing children with MAM to those defined as healthy revealed significantly lower relative microbiota maturity, MAZ and differences in the relative abundances of age-discriminatory taxa in the malnourished group (FIGS. 11D-L and FIGS. 12A,B). These results suggest that microbiota immaturity may be an additional pathophysiological component of moderately malnourished states.

In conclusion, definition of microbiota maturity using bacterial taxonomic biomarkers that are highly discriminatory for age in healthy children has provided a way to characterize malnourished states, including whether responses to food interventions endure for prolonged periods of time beyond the immediate period of treatment. RUTF and Khichuri-Halwa produced improvements in microbiota maturity indices that were not sustained. Addressing the question of how to achieve durable responses in children with varying degrees of malnutrition may involve extending the period of administration of existing or new types of food interventions⁷. One testable hypothesis is that a population's microbiota conditioned for generations on a diet will respond more favourably to nutrient supplementation based on food groups represented in that diet. Next-generation probiotics using gut-derived taxa may also be required in addition to food-based interventions. The functional roles (niches) of the age-discriminatory taxa identified by our Random Forests model need to be clarified since they themselves maybe therapeutic candidates and/or form the basis for low cost field-based diagnostic assessments.

Systematic analyses of microbiota maturation in different healthy and malnourished populations living in different locales, representing different lifestyles andculturaltraditions^(11,18), may yield a taxonomy-based model that is generally applicable to many countries and types of diagnostic and therapeutic assessments. Alternatively, these analyses may demonstrate a need for geographic specificity when constructing such models (and diagnostic tests or therapeutic regimens). Two observations are notable in this regard. First, expansion of our sparse model from 24 to 60 taxa yielded similar results regarding the effects of diarrhoea in healthy individuals, MAM and SAM (and its treatment with RUTF and Khichuri-Halwa) on microbiota maturity (see Example 8). Second, we applied the model that we used for Bangladeshi children to healthy children in another population at high risk for malnutrition. The results show that the model generalizes (r²=0.6) to a cohort of 47 Malawian twins and triplets, aged 0.4-25.1 months, who were concordant for healthy status in a previous study¹¹ (WHZ, −0.23±0.97(mean±s.d.); Table 16). Age-discriminatory taxa identified in healthy Bangladeshi children show similar age-dependent changes in their representation in the microbiota of healthy Malawian children, as assessed by the Spearman rank correlation metric (FIG. 12C,D).

The question of whether microbiota immaturity associated with SAM and MAM is maintained during and beyond childhood also underscores the need to determine the physiologic, metabolic and immunologic consequences of this immaturity, and how they might contribute to the associated morbidities and sequelae of malnutrition, including increased risk for diarrhoeal disease, stunting, impaired vaccine responses, and cognitive abnormalities^(2,19). Our study raises a testable hypothesis: namely, that assessments of microbiota maturation, including in the context of the maternal-infant dyad, will provide a more comprehensive view of normal human development and of developmental disorders, and generate new directions for preventive medicine. Testing this hypothesis will require many additional clinical studies but answers may also arise from analyses of gut microbiota samples that have already been stored from previous studies.

Example 2 Anthropologic Assessment

The study population resided in the Mirpur slum of Dhaka, Bangladesh (23.8042° N 90.3667° E) in a catchment area consisting of 9,250 households. Most of the homes in this community consist of one main room (˜220 square feet), composed of concrete floors and tin roofs with bamboo, metal, and in a few cases cement walls. The average number of household members ranges from 4-10 people, and average monthly family income is 4,000-10,000 Bangladeshi Taka (50 to 130 USD). Infants do not wear diapers, nor do they typically wear any clothing on the bottom halves of their bodies. The importance of hand washing before eating or child feeding is widely understood but rarely practiced due to lack of access to clean water. Families prepare food either on the floor or on a ground-level cement slab located at the entrance of the home; this slab typically straddles an open drain containing wastewater running along the street. Since few families have refrigerators, most food is stored on shelves or under the bed. Households may consist of more than one biological family: in these cases all individuals in the household share a gas stove and cooking area immediately outside the main room, although food, cooking pots and utensils are used separately by each biological family. All individuals share a common ‘bathroom,’ a small space containing a latrine, and sometimes the water pump, located next to the main room. The common practice is to wash the perianal area by hand with water contained in a small, special container called bodna in Bangla.

Example 3 Fecal Microbiota Variation within and Between Family Members During the First Year of Postnatal Life

There are few reports of time-series studies charting assembly of the gut microbiota in healthy USA infants and even fewer studies in infants from non-Western populations. The results published to date have revealed pronounced intra—as well as interpersonal variation during the first year of life^(11,29-31). In contrast, the gut microbiota of healthy USA adults is quite stable over time, with signatures of within-individual and within-family similarity evident throughout sampling periods¹⁵.

To obtain a view of gut microbiota development in Bangladeshi infants and children as a function of time after birth and family structure, we collected monthly fecal samples from 11 twin pairs and 1 set of triplets and their parents. The first fecal sample was obtained from infants at the time of their enrollment (4±3 days of age). Monthly samples were subsequently obtained from each of these 25 infants and from their mothers while samples were collected from their fathers every three months. Families were followed for a total of 520±159 days (mean±SD). The duration of exclusive breastfeeding was 28±23 days (mean±SD). Diarrhoea occurred for 11±12 days (2±3% of the total number of days followed during the study).

Distances (degree of similarity) between all pairs of fecal microbiota samples in this birth cohort were computed using the Hellinger metric, an abundance-based ecological metric, as well as the phylogeny-based unweighted UniFrac metric where distance is calculated based on the degree to which any two communities share branch length on a bacterial tree of life³². In the case of triplets, we performed all possible pairwise comparisons (self-self; all three possible pairwise comparisons among siblings; each sibling against unrelated age-matched individuals; each sibling against their mother or father).

We had previously noted that genetically unrelated co-habiting adults in the USA have more similar overall bacterial phylogenetic configurations in their fecal microbiota than unrelated adults living separately¹¹. Comparing the difference (distance) of a Bangladeshi mother's microbiota during her first month post-partum to her microbiota three months later revealed a larger shift in overall structure compared to fathers sampled during the same three-month interval [P=0.01 (Hellinger); P=0.04 (unweighted UniFrac); FIG. 5C,D], thus obscuring a microbial manifestation of their co-habitation. This signature of co-habitation emerged 10 months postpartum, at a time when the preceding marked temporal variation of the mother's microbiota had diminished (P=0.006 for difference between co-habiting spouses at 10 months postpartum versus non-co-habiting adults in the cohort as measured by the abundance based Hellinger metric; P=0.08 using the presence/absence unweighted UniFrac phylogenetic metric; see FIG. 5E,F).

During the first postnatal month, the bacterial configuration of the fecal microbiota of infants was more similar to mothers compared to fathers (P<0.001 Hellinger metric; P=0.07 with unweighted UniFrac; FIG. 5G,H). Co-twins were more similar to one another than unrelated age-matched twins during the first postpartum year (P<0.001 Kruskall-Wallis; FIG. 51,J). An analysis of sources of variation in the microbiota of the twins and triplets over the course of the entire study revealed that age alone captured 19% and 37.7% of variance (Hellinger and unweighted UniFrac metrics, respectively) in contrast to dietary factors (presence/absence of ‘breast milk’, ‘formula’, ‘solid foods’) which explained only 2.5% and 3.8%, respectively (see Table 7 for partitioning of variance by metric and metadata; PERMANOVA as implemented with adonis function in R package vegan)³³.

We identified increases in the proportional representation of 97%-identity OTUs in the microbiota of mothers during the perinatal period, including a number of the age-discriminatory taxonomic biomarkers, notably Bifidobacteria in FIGS. 5A,B and Table 8. This latter feature is not unique to Bangladesh: a recent study of 80 Finnish mother-infant pairs sampled at 1 and 6 months post-partum demonstrated that if a mother was positive for B. bifidum 1 month following delivery, the likelihood of her child being colonized was significantly higher³⁴).

Example 4 Transient Reduction of Gut Microbiota Diversity in Healthy Twins and Triplets Associated with Diarrhea

In addition to changes in the relative proportions of specific bacterial taxa incorporated into our Random Forests model-derived MAZ and relative microbiota maturity metrics, the developing gut microbiota of infants/children is also characterized by an increase in total community bacterial diversity as judged by the Shannon Diversity Index (SDI). SDI is an ecological measure of within-sample (alpha) diversity that incorporates both the concept of total community size as well as the evenness of the abundance of its members. Across the 50 healthy Bangladeshi children sampled, SDI increased linearly with age (0.11 units per month of life with an intercept of 1.6±0.1 units at birth; mixed model; P<0.0001). In twins and triplets, diarrhoea (n=36 episodes) was the only significant clinical parameter associated with a reduction in SDI (−0.44±0.1; P<0.01). This reduction showed a similar time course of recovery as relative microbiota maturity, persisting for one month (−0.35±0.2 SDI; P<0.05) followed by subsequent recovery (FIG. 4; Table 6c).

Example 5 Persistent Reductions in Diversity Associated with SAM

As with measurements of microbiota maturity, the RUTF group showed significant improvement in SDI values between 1-3 months following cessation of treatment, followed by regression to a persistent lower than healthy SDI beyond 3 months. In the case of Khichuri-Halwa, improvement in SDI was only significant at 3-4 months of follow-up. SAM children in both treatment groups exhibited significant reductions in diversity compared to healthy Bangladeshi children at all phases of treatment and recovery, except for 1-3 months post-RUTF and 3-4 months post-Khichuri-Halwa (FIG. 7; Table 12).

Example 6 Two Hundred and Twenty Bacterial Taxa that are Significantly Different in their Proportional Representation in Microbiota of Children with SAM Compared to Healthy at Multiple Treatment Phases Across Both Groups

During the acute phase, prior to nutritional rehabilitation, 116 97%-identity OTUs were significantly altered in SAM. The majority were lower in relative abundance compared to healthy children. The four 97% identity OTUs with the largest reductions in abundance during the acute phase included three classified as belonging to the genus Bifidobacterium (B. longum, two unassigned to a species) and Faecalibacterium prausnitzii, of which two are age-discriminatory taxa (FDR-corrected P<0.05). Taxa that were enriched in children diagnosed with SAM compared to healthy children included those belonging to the family Enterobacteriaceae (genera Escherichia and Klebsiella) as well as Enterococcus faecalis (FDR-corrected P<0.05).

In children with SAM, taxa that remain depleted throughout the follow-up period included members of the bacterial families Ruminococcaceae, Veillonellaceae and Prevotellaceae. Taxa enriched in the microbiota of children with SAM after the therapeutic food interventions belonged predominantly to the genus Streptococcus, including 97% ID OTUs identified as Streptococcus lutentiensis, Streptococcus thermophilus (also age-discriminatory) and other as yet unknown Streptococcus species (FDR-corrected P<0.01; see FIG. 8 and FIG. 9 for a heatmap depiction of all 97% ID OTUs whose representation in the fecal microbiota is significantly altered in SAM relative to healthy before, during and after the nutritional rehabilitation period; also see Table 13).

Example 7 Assessing the Effects of Antibiotics on Microbiota Maturity During the Follow-Up Period in Children with SAM

As noted in Example 1, we compared antibiotic use during the post-intervention periods for the two treatment arms. The results indicate that (i) the frequency of antibiotic consumption during this period was comparable to that of healthy children in our training and validation sets (P=0.5, one-way ANOVA); (ii) there was no significant difference in antibiotic use between treatment arms (P=1; Fisher's exact test; Table 10); (iii) there was no significant association between recent antibiotic intake (defined as occurring seven or fewer days before collection of a fecal sample) and relative microbiota maturity values [difference in maturity values for samples with versus those without recent antibiotic intake: −0.37±0.8 (mean±SEM) P=0.6 (ANOVA of linear mixed model; n=100 samples for the 22 children in the post RUTF arm); +0.17±0.9; P=0.9 (n=103 samples, 25 children in the Khichuri-Halwa arm)]. Similarly, we found that diarrhoea was not significantly associated with differences in maturity values in either arm during the post-intervention period (Table 14).

Example 8 Expanding the Sparse Random Forests-Based Model from 24 to 60 Taxa

It is logical to ask the following questions about our approach for defining microbiota maturity. First, are we defining “immaturity” entirely as a lack of maturity, rather than a specific, recognizable state in and of itself. Ours is a ‘positive’ composition-based classification. For example, the Bifidobacterium longum OTU in FIG. 1A ranks 5^(th) in terms of its feature importance score in the 24-taxon Random Forests model. In samples from healthy infants less than 6 months old, this OTU is highly represented [relative abundance=52.7±30% (mean±SD); >1% in 94% of samples from the training and validation sets). The remaining seven 97%-identity OTUs that comprise the cluster of early age-discriminatory taxa shown in FIG. F-H together represent 6.35±8% of the microbiota and are present at >1% abundance in 84% of samples.

Second, was there an outlet for samples containing very few or none the 24 taxa selected by the model? For example, were they deemed unclassifiable, or classified as “other”, or were all samples “forced” onto the maturity scale? How were samples with low feature signal having few to no age-discriminant taxa classified? Only one of the 589 fecal samples in the SAM study had undetectable levels of the 24 age-discriminatory taxa. In the SAM cohort, only 10% of fecal samples (60/589) had an aggregate relative abundance of the 24 age-discriminatory taxa that was less than 10%. In healthy children, this was true for 36/960 samples.

When we expanded our model to include the top 60 age-discriminatory taxa, we found that <1% of SAM samples and none of the healthy samples had an aggregate relative abundance of the 60 age-discriminatory taxa that was less than 10%. Note that in expanding the model, we excluded OTUs that were deemed chimeric when using default BLAST thresholds to the Greengenes reference as implemented in QIIME. The performance of the 24 and 60 taxa models were similar. Predictions made by the two models when they were applied to the healthy validation datasets (all 724 samples considered), and when they were applied to the SAM datasets (all 589 samples considered), showed a strong correlation (r²=0.98 and 0.93, respectively). Both yielded similar results for our analysis of (i) the effects of diarrhoea in healthy twins/triplets (microbiota immaturity was transient), (ii) the SAM trial (the effects of RUTF and Khichuri-Halwa produced transient non-durable improvements compared to healthy controls; antibiotics did not have a significant effect on microbiota maturity measurements either during the acute phase or during the post-intervention; note that the top 60 model includes Enterobacteriaceae and Streptococcaceae OTUs that are highly enriched in children with SAM relative to healthy); and (iii) the MAM study (a significant difference was observed between 18 month old healthy controls versus children with MAM) (data not shown).

Example 9 Processed 16S rRNA Datasets

Processed 16S rRNA datasets are available here, http://gordonlab.wustl.edu/Subramanian_6_14/Nature_2014_Processed_16 S_rRNA_da tasets.html, as a BIOM-formatted OTU table, along with split libraries of data generated from faecal samples and ‘Mock’ communities, mapping file, and an augmented reference sequence set (Greengenes version 4feb2011 plus de novo OTUs picked from sequences generated in the present study).

Methods for Examples 1-9 Summary

All subjects lived in Dhaka, Bangladesh (see Anthropologic Study below and Example 2 for anthropologic assessment of Mirpur, an urban slum in Bangladesh, where most subjects resided). Informed consent was obtained and studies were conducted using protocols approved by the ICDDR,B, Washington University, and University of Virginia institutional review boards (IRBs). Linear mixed models were applied to test hypotheses in repeated measurements of relative abundance of 97%-identity OTUs and maturation metrics in time-series profiling of faecal microbiota²⁰. To account for similarity between observations from repeated sampling of the same individuals and families, we fit random intercepts for each subject in the case of adults and singletons, nested these intercepts within each family in the case of twins and triplets, and included age as a fixed-effect covariate, while testing the significance of associations between the microbiota and specified host and environmental factors. Differences between microbiota maturation metrics in each treatment phase of SAM were compared to values at enrollment in each treatment group, and to healthy children within the same age range (excluding samples from children used to train the Random Forests model), using analysis of variance (ANOVA) of linear mixed models followed by Dunnett's post-hoc comparisons.

Singleton Birth Cohort.

Full details of the design of this now-complete birth cohort study have been described previously²¹. Faecal microbiota samples were profiled from 25 children who had consistently healthy anthropometric measures based on quarterly (every 3 months) measurements (Table 1). The WHZ threshold used for ‘healthy’ (on average above −2 s.d.) was based on median weight and height measurements obtained from age- and gender-matched infants and children by the Multi-Centre Growth Reference study of the World Health Organization³. Clinical parameters, including diarrhoeal episodes and antibiotic consumption associated with each of their faecal samples are provided in Supplementary Table 2 of Subramanian et al, Nature 2014; S10:417-421, which is hereby incorporated by reference in its entirety.

A second group studied from this singleton cohort consisted of 33 children sampled cross-sectionally at 18 months, including those who were incorporated as healthy reference controls, and those with a WHZ <−2 who were classified with MAM (Table 15).

Twins and Triplets Birth Cohort.

Mothers with multiple pregnancy, identified by routine clinical and sonographic assessment at the Radda Maternal Child Health and Family Planning (MCH-FP) Clinic in Dhaka, were enrolled in a prospective longitudinal study (n=11 mothers with twins, 1 mother with triplets). The zygosity of twin pairs and triplets was determined using plasma DNA and a panel of 96 polymorphic single-nucleotide polymorphisms (SNPs) (Center for Inherited Disease Research, Johns Hopkins University). Four twin pairs were monozygotic, six were dizygotic, and the set of triplets consisted of a monozygotic pair plus one fraternal sibling (Table 1; note that one of the 11 twin pairs could not be tested for zygosity because plasma samples were not available). Information about samples from healthy twins, triplets and their parents, including clinical parameters associated with each faecal sample, is provided in Table 2 and in Supplementary Table 2 of Subramanian et al, Nature 2014; S10:417-421, which is hereby incorporated by reference in its entirety.

The three healthy Bangladeshi groups used for model training and validation had the following WHZ scores: −0.32 6 1 (mean 6 s.d.; 12 singletons randomized to the training set), −0.4460.8 (13 singletons randomized to one of the two validation sets), and −0.466 0.7 (twins and triplets in the other validation set) (Table 3). The average number of diarrhoeal episodes in the singleton training set, the singleton validation set, and the twin and triplet validation set (4, 4.6 and 1.7, respectively) was comparable to values reported in previous surveys of another cohort of 0-2-year-old Bangladeshi children (4.25 per child per year)²².

There were no significant differences in the number of diarrheal episodes per year per child and the number of diarrhoeal days per year per child between the singleton training and validation sets (Student's t-test, P 5 0.5). Moreover, across all training and validation sets, neither of these diarrheal parameters correlated with mean age-adjusted Shannon diversity indices (Spearman's Rho, −0.18 and −0.12, P 5 0.22 and 0.4, respectively). The fraction of faecal samples collected from each child where oral antibiotics had been consumed within the prior 7 days was not significantly different between the training and two validation sets (one-way ANOVA, P 5 0.14; see Table 3).

Severe Acute Malnutrition Study.

Sixty-four children in the Nutritional Rehabilitation Unit of ICDDR,B, Dhaka Hospital suffering from SAM (defined as having a WHZ less than −3 s.d. and/or bilateral pedal oedema) were enrolled in a randomized interventional trial to compare an imported peanut-based RUTF, Plumpy'Nut (Nutriset Plumpyfield, India) and locally produced Khichuri-Halwa (clinical trial NCT01331044). Initially, children were stabilized by rehydration and feeding ‘suji’, which contains whole bovine milk powder, rice powder, sugar and soybean oil (approximately 100 kcal kg⁻¹ body weight per day, including 1.5 g protein kg⁻¹ per day). Children were then randomized to the Khichuri-Halwa or RUTF groups. Khichuri consists of rice, lentils, green leafy vegetables and soybean oil; Halwa consists of wheat flour (atta), lentils, molasses and soybean oil. Children randomized to the Khichuri-Halwa treatment arm also received milk suji ‘100’ during their nutritional rehabilitation phase (a form of suji with a higher contribution of calories from milk powder compared to suji provided during the acute phase). RUTF is a ready-to-use paste that does not need to be mixed with water; it consists of peanut paste mixed with dried skimmed milk, vitamins and minerals (energy density, 5.4 kcalg⁻¹). Khichuri and Halwa are less energy-dense than RUTF (1.45 kcal g-1 and 2.4 kcal g⁻¹, respectively, see Table 11 for a list of ingredients for all foods used during nutritional rehabilitation).

The primary outcome measurement, rate of weight gain (g kg⁻¹ per day), along with improvement in WHZ after nutritional rehabilitation are reported by child in Table 9. Faecal samples were collected before randomization to the RUTF and Khichuri-Halwa treatment arms, every 3 days during nutritional rehabilitation and once a month during the follow-up period (information associated with each faecal sample is provided in Supplementary Table 11 of Subramanian et al, Nature 2014; S10:417-421, which is hereby incorporated by reference in its entirety).

Anthropologic Study.

To obtain additional information about household practices in the Mirpur slum of Dhaka, in-depth semi-structured interviews and observations were conducted over the course of 1 month in nine households (n=30 individuals). This survey, approved by the Washington University and ICDDR,B IRBs, involved three ICDDR,B field research assistants, and three senior scientific staff in the ICDDR,B Centre for Nutrition and Food Security, plus two anthropologists affiliated with Washington University in St. Louis. Parameters that might affect interpretation of metagenomic analyses of gut microbial-community structure were noted, including information about daily food preparation, food storage, personal hygiene and childcare practices.

Characterization of the Bacterial Component of the Gut Microbiota by V4-16S rRNA Sequencing.

Faecal samples were frozen at −20° C. within 30 min of their collection and subsequently stored at −80° C. before extraction of DNA. DNA was isolated by bead-beating in phenol and chloroform, purified further (QIAquick column), quantified (Qubit) and subjected to polymerase chain reaction (PCR) using primers directed at variable region 4 (V4) of bacterial 16S rRNA genes. Bacterial V4-16S rRNA data sets were generated by multiplex sequencing of amplicons prepared from 1,897 faecal DNA samples (26,580 6 26,312 (mean 6 s.d.) reads per sample, paired-end 162- or 250-nucleotide reads; Illumina MiSeq platform; Table 4). Reads of 250 nucleotides in length were trimmed to 162 nucleotides, then all reads were processed using previously described custom scripts, and overlapped to 253-nucleotide fragments spanning the entire V4 amplicon¹⁵. ‘Mock’ communities, consisting of mixtures of DNAs isolated from 48 sequenced bacterial members of the human gut microbiota combined in one equivalent and two intentionally varied combinations, were included as internal controls in the Illumina MiSeq runs. Data from the mock communities were used for diversity and precision-sensitivity analyses employing methods described previously^(15,23).

Reads with ≥97% nucleotide sequence identity (97%-identity) across all studies were binned into operational taxonomic units (OTUs) using QIIME (v 1.5.0), and matched to entries in the Greengenes reference database (version 4feb2011)^(24,25). Reads that did not map to the Greengenes database were clustered de novo with UCLUST at 97%-identity and retained in further analysis. A total of 1,222 97%-identity OTUs were found to be present at or above a level of confident detection (0.1% relative abundance) in at least two faecal samples from all studies. Taxonomy was assigned based on the naive Bayesian RDP classifier version 2.4 using 0.8 as the minimum confidence threshold for assigning a level of taxonomic classification to each 97%-identity OTU.

Definition of Gut-Microbiota Maturation in Healthy Children Using Random Forests.

Random Forests regression was used to regress relative abundances of OTUs in the time-series profiling of the microbiota of healthy singletons against their chronologic age using default parameters of the R implementation of the algorithm (R package ‘randomForest’, ntree 5 10,000, using default mtry of p/3 where p is the number of input 97%-identity OTUs (features))²⁶. The Random Forests algorithm, due to its non-parametric assumptions, was applied and used to detect both linear and nonlinear relationships between OTUs and chronologic age, thereby identifying taxa that discriminate different periods of postnatal life in healthy children. A rarefied OTU table at 2,000 sequences per sample served as input data. Ranked lists of taxa in order of Random Forests reported ‘feature importance’ were determined over 100 iterations of the algorithm. To estimate the minimal number of top ranking age-discriminatory taxa required for prediction, the rfcv function implemented in the ‘randomForest’ package was applied over 100 iterations. A sparse model consisting of the top 24 taxa was then trained on the training set of 12 healthy singletons (272 faecal samples). Without any further parameter optimization, this model was validated in other healthy children (13 singletons, 25 twins and triplets) and then applied to samples from children with SAM and MAM. A smoothing spline function was fit between microbiota age and chronologic age of the host (at the time of faecal sample collection) for healthy children in the validation sets to which the sparse model was applied.

Alpha Diversity Comparisons.

Estimates of within-sample diversity were made at a rarefaction depth of 2,000 reads per sample. A linear regression was fit between the Shannon diversity index (SDI) and postnatal age in the 50 healthy children using a mixed model (see the additional details regarding statistical methods, below). An estimate of the coefficient for the slope of SDI with age and intercept was extracted, residuals of this regression were defined as a DSDI metric, and associations of this metric with clinical parameters were tested in the cohort of healthy twins and triplets. To test for differences in SDI as a function of health status and chronologic age in malnourished children, we compared the distribution of age-adjusted ΔSDIs in children with SAM between treatment phases.

Detection of Associations of Bacterial Taxa with Nutritional Status and Other Parameters.

Relative abundances of 97%-identity OTUs were used in linear mixed models as response variables to test for associations with clinical metadata as predictors. For each comparison, we restricted our analysis to 97%-identity OTUs and bacterial families whose relative abundance values reached a level of confident detection (0.1%) in a minimum of 1% of samples in each comparison. Pseudocounts of 1 were added to 97%-identity OTUs to account for variable depth of sequencing between samples, and relative abundances were arcs in-square-root-transformed to approximate homoscedasticity when applying linear models. P values of associations of factors with the relative abundances of bacterial taxa were computed using ANOVA type III (tests of fixed effects), subjected to Benjamini-Hochberg false discovery rate (FDR) correction.

Enteropathogen Testing.

Clinical microscopy was performed for all faecal samples collected at monthly intervals from the singleton birth cohort and from healthy twins and triplets, and screened for Entamoeba histolytica, Entamoeba dispar, Escherichia coli, Blastocystis hominis, Trichomonas hominis, Blastocystis hominis, Coccidian-like bodies, Giardia lamblia, Ascaris lumbricoides, Trichuris Tricuria, Ancylostoma duodenale/Necator americanus, Hymenolepsis nana, Endolimax nana, lodamoebabutschlii and Chilomastixmesnili. The effects of enteropathogens, detected by microscopy on relative microbiota maturity, MAZ and SDI were included in our analysis of multiple environmental factors in FIG. 4 and Table 6. In cases in which children presented with SAM plus diarrhoea, faecal samples collected before nutritional rehabilitation were cultured for Vibrio cholerae, Shigella flexneri, Shigella boydi, Shigella sonnei, Salmonella enterica, Aeromonas hydrophila and Hafnia alvae. See Tables 9 and 17 for results of enteropathogen testing.

Additional Details Regarding Statistical Methods.

Linear mixed models were applied to test for associations of microbiota metrics (relative microbiota maturity, MAZ and SDI) with genetic and environmental factors in twins and triplets. Log-likelihood ratio tests and F tests were used to perform backward elimination of non-significant random and fixed effects²⁷. Relative microbiota maturity, MAZ and SDI were defined at different phases of treatment and at defined periods of follow-up (<1 month, 1-2, 3-4 and >4 months after completion of the RUTF or Khichuri-Halwa nutritional intervention) in children with SAM relative to healthy children. ‘Treatment phase’ was specified as a categorical multi-level factor in a univariate mixed model with random by-child intercepts. Dunnett's post-hoc comparison procedure was performed to compare each treatment phase relative to healthy controls and relative to samples collected at enrollment in each food intervention group.

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Example 10 Members of the Human Gut Microbiota Involved in Recovery from Vibrio cholerae Infection

We used an approved protocol for recruiting Bangladeshi adults living in Dhaka Municipal Corporation area for this study. Of the 1,153 patients with acute diarrhoea who were screened, seven passed all entry criteria (Methods for Examples 10-17) and were enrolled (Tables 18 and 19). Faecal samples collected at monthly intervals during the first 2 postnatal years from 50 healthy children living in the Mirpur area of Dhaka city, plus samples obtained at approximately 3-month intervals over a 1-year period from 12 healthy adult males also living Mirpur, allowed us to compare recovery of the microbiota from cholera with the normal process of assembly of the gut community in infants and children, and with unperturbed communities from healthy adult controls.

Using the standard treatment protocol of the International Centre for Diarrhoeal Disease Research, Bangladesh, study participants with acute cholera received a single oral dose of azithromycin and were given oral rehydration therapy for the duration of their hospital stay. Patients were discharged after their first solid stool. We divided the diarrhoeal period (from the first diarrhoeal stool after admission to the first solid stool) into four proportionately equal time bins: diarrhoeal phase 1 (D-Ph1) to D-Ph4. Every diarrhoeal stool was collected from every participant. Faecal samples were also collected every day for the first week after discharge (recovery phase 1, R-Ph1), weekly during the next 3 weeks (R-Ph2), and monthly for the next 2 months (R-Ph3). For each individual, we selected a subset of samples from D-Ph1 to D-Ph3 (Methods for Examples 10-17), plus all samples from D-Ph4 to R-Ph3, for analysis of bacterial composition by sequencing PCR amplicons generated from variable region 4 (V4) of the 16S ribosomal RNA (rRNA) gene (FIG. 15A and Supplementary Table 3 of Hsiao et al, Nature 2014; Epub, which is hereby incorporated by reference in its entirety). Reads sharing 97% nucleotide sequence identity were grouped into operational taxonomic units (97%-identity OTUs; Methods for Example 10-17).

We identified a total of 1,733 97%-identity OTUs assigned to 343 different species after filtering and rarefaction (Methods for Example 10-17). V. cholerae dominated the microbiota of the seven patients with cholera during D-Ph1 (mean maximum relative abundance 55.6%), declining markedly within hours after initiation of oral rehydration therapy. The microbiota then became dominated by either an unidentified Streptococcus species (maximum relative abundance 56.2-98.6%) or by Fusobacterium species (19.4-65.1% in patients B-E). In patient G, dominance of the community passed from a Campylobacter species (58.6% maximum) to a Streptococcus species (98.6% maximum) (Table 20 and Supplementary Table 4 of Hsiao et al, Nature 2014; Epub, which is hereby incorporated by reference in its entirety). Of the 343 species, 47.9±6.6% (mean±s.d.) were observed throughout both the diarrhoeal and recovery phases, suggesting that microbiota composition during the recovery phase may reflect an outgrowth from reservoirs of bacteria retained during disruption by diarrhoea (FIG. 16).

Indicator species analysis ⁴ (Methods for Example 10-17) was used to identify 260 bacterial species consistently associated with the diarrhoeal or recovery phases across members of the study group, and in a separate analysis for each subject (Table 21). The relative abundance of each of the discriminatory species in each faecal sample was compared with the mean weighted phylogenetic (UniFrac) distance between that microbiota sample and all microbiota samples collected from the reference cohort of healthy Bangladeshi adults. The results revealed 219 species with significant indicator value assignments to diarrhoeal or recovery phases, and relative abundances with statistically significant Spearman's rank correlation values to community UniFrac distance to healthy control microbiota (Table 22 and FIG. 16F-N). Not surprisingly, the abundance of V. cholerae directly correlated with increased distance to a healthy microbiota. Streptococcus and Fusobacterium species, which bloomed during the early phases of diarrhoea, were also significantly and positively correlated with distance from a healthy adult microbiota. Increases in the relative abundances of species in the genera Bacteroides, Prevotella,Ruminococcus/Blautia, and Faecalibacterium (for example, Bacteroides vulgatus, Prevotella copri, R obeum, and Faecalibacterium prausnitzii) were strongly correlated with a shift in community structure towards a healthy adult configuration (FIGS. 16F-N and Table 22).

Previously we used Random Forests, a machine-learning algorithm, to identify a collection of age-discriminatory bacterial taxa that together define different stages in the postnatal assembly/maturation of the gut microbiota in healthy Bangladeshi children living in the same area as the adult patients with cholera ³ . Of those 60 most age-discriminatory 97%-identity OTUs representing 40 different species, 31 species were present in adult patients with cholera. Intriguingly, they followed a similar progression of changing representation during diarrhoea to recovery as they do during normal maturation of the healthy infant gut microbiota (FIG. 16F-N). Twenty-seven of the 31 species were significantly associated with recovery from diarrhoea by indicator species analysis (see FIG. 17, 18, 19 for OTU-level and community-wide analyses). These 27 species, which serve as indicators and are potential mediators of restoration of the gut microbiota after cholera, guided construction of a gnotobiotic mouse model that examined the molecular mechanisms by which some of these taxa might affect V. cholerae infection and promote restoration.

We assembled an artificial community of 14 sequenced human gut bacterial species (Table 23) that included (1) five species that directly correlated with gut microbiota recovery from cholera and with normal maturation of the infant gut microbiota (R. obeum, Ruminococcus torques, F. prausnitzii, Dorea longicatena, Collinsella aerofaciens), (2) six species significantly associated with recovery from cholera by indicator species analysis (Bacteroides ovatus, Bacteroides vulgatus, Bacteroides caccae, Bacteroides uniformis, Parabacteroides distasonis, Eubacterium rectale), and (3) three prominent members of the adult human gut microbiota that have known capacity to process dietary and host glycans (Bacteroides cellulosilyticus, Bacteroides thetaiotaomicron, Clostridium scindens ^(6,7,8); as noted in FIG. 20 and Table 24 and Supplementary Table 8 of Hsiao et al, Nature 2014; Epub, which is hereby incorporated by reference in its entirety, shotgun sequencing of diarrhoeal- and recovery-phase human faecal DNA samples revealed that genes encoding enzymes involved in carbohydrate metabolism were the largest category of identified genes specifying known enzymes that changed in relative abundance within the faecal microbiome during the course of cholera). One group of mice was directly inoculated with approximately 10⁹ colony-forming units (c.f.u.) of V. cholerae at the same time they received the 14-member community to simulate the rapidly expanding V. cholerae population during diarrhoea (‘D1 invasion’ group). A separate group was gavaged with the community alone and then invaded 14 days later with V. cholerae (‘D14invasion’ group) (FIG. 15C,D).

V. cholerae levels remained at a high level in the D1 invasion group over the first week (maximum 46.3% relative abundance), and then declined rapidly to low levels (<1%). Introduction of V. cholerae into the established 14-member community produced much lower levels of V. cho/eraeinfection (range of mean abundances measured daily over the 3 days after gavage of the enteropathogen, 1.2-2.7%; Table 25). Control experiments demonstrated that V. cholerae was able to colonize at high levels for at least 7 days when it was introduced alone into germ-free recipients (10⁹-10¹⁰ c.f.u. per milligram wet weight of faeces; FIG. 13A,B). Together, these data suggest that a member or members of the artificial human gut microbiota had the ability to restrict V. cholerae colonization.

Changes in relative abundances of the 14 community members in faecal samples in response to V. cholerae were consistent for most species across the D1 invasion and D14invasion mice (Table 25). We focused on one member, R. obeum, because its relative abundance increased significantly after introduction of V. cholerae in both the D1 invasion and D14invasion groups (FIG. 21A and Table 25) and because it is a prominent age-discriminatory taxon in the Random Forests model of gut microbiota maturation in healthy Bangladeshi children³ (FIG. 18J). Mice were mono-colonized with either R. obeum or V. cholerae for 7 days and then the other species was introduced (FIG. 15E,F). When R. obeum was present, V. cholerae levels declined by 1-3 logs (FIG. 13A,B). Germ-free mice were also colonized with the defined 14-member community or the same community without R. obeum for 2 weeks, and V. cholerae was then introduced by gavage (FIG. 15G,H). V. choleraelevels 1 day after gavage were 100-fold higher in the community that lacked R. obeum; these differences were sustained over time (50-fold higher after 7 days; P<0.01, unpaired Mann-Whitney U-test; FIG. 13A,B).

Having established that R. obeum restricts V. cholerae colonization, we used microbial RNA sequencing (RNA-seq) of faecal RNAs to determine the effect of R. obeum on expression of known V. cholerae virulence factors in mono- and co-colonized mice. Co-colonization led to reduced expression of tcpA (a primary colonization factor in humans⁹′¹⁰), rtxA and hlyA (encode accessory toxins^(11,12)), and VC1447-VC1448 (RtxA transporters) (threefold to fivefold changes; P<0.05 compared with V. cholerae mono-colonized controls, Mann-Whitney U-test; see Table 26 for other regulated genes that could impact colonization, plus FIG. 22 for an ultra-performance liquid chromatography mass spectrometry (UPLC-MS) analysis of bile acids reported to effect V. cholerae gene regulation¹³).

Two quorum-sensing pathways are known to regulate V. cholerae colonization/virulence^(14,15,16,17): an intra-species mechanism involving cholera autoinducer-1, and an inter-species mechanism involving autoinducer-2^(18,19). Quorum sensing disrupts expression of V. cholerae virulence determinants through a signalling pathway that culminates in production of the LuxR-family regulator HapR^(15,16). Repression of quorum sensing in V. cholerae is important for virulence factor expression and infection^(20,21,22.) The luxS gene encodes the S-ribosylhomocysteine lyase responsible for Al-2 synthesis. Homologues of luxS are widely distributed among bacteria^(18,19), including 8 of the 14 species in the artificial human gut community (Table 27 and FIG. 23). RNA-seq of the faecal meta-transcriptomes of D1 invasion mice colonized with the 14-member artificial community plus V. cholerae, and mice harbouring the 14-member consortium without V. cholerae, revealed that of predicted luxS homologues in the community, only expression of R. obeum luxS (RUMOBE02774) increased significantly in response to V. cholerae(P<0.05, Mann-Whitney U-test; FIG. 13C). Moreover, R. obeum luxS transcript levels directly correlated with V. cholerae levels (FIG. 21D).

In addition to luxS, the R. obeum strain represented in the artificial community contains homologues of IsrABCK that are responsible for import and phosphorylation of Al-2 in Gram-negative bacteria²³, as well as homologues of two genes, luxR and luxQ, that play a role in Al-2 sensing and downstream signalling in other organisms²⁴. Expression of all these R. obeum genes was detected in vivo, consistent with R. obeum having a functional Al-2 signalling system (FIG. 21B,C). (See Example 17 for results showing that R. obeum Al-2 production is stimulated by V. cholerae in vitro and in co-colonized animals (FIG. 21E-G), plus (1) a genome-wide analysis of the effects of V. cholerae on R. obeum transcription in co-colonized mice (Table 26c) and (2) a community-wide view of the transcriptional responses of the 14-member consortium to V. cholerae (Table 28).)

Quorum sensing downregulates the V. cholerae tcp operon that encodes components of the toxin co-regulated pilus (TCP) biosynthesis pathway required for infection of humans^(9,10). To confirm that R. obeum LuxS could signal through Al-2 pathways, we cloned R. obeum and V. cholerae luxS downstream of the arabinose-inducible P_(BAD) promoter in plasmids that were maintained in an Escherichia coli strain unable to produce its own Al-2 (DH5a)²⁵. High tcp expression can be induced in V. cholerae after slow growth in AKI medium without agitation followed by rapid growth under aerobic conditions²⁶. Addition of culture supernatants harvested from the E. coli strains expressing R. obeum or V. cholerae luxS caused a two- to threefold reduction in tcp induction in V. cholerae (P<0.05, unpaired Student's t-test; replicated in four independent experiments). Supernatants from a control E. coli strain with the plasmid vector lacking luxS had no effect (FIG. 14A). These findings are consistent with our in vivo RNA-seq results and provide direct evidence that R. obeum Al-2 regulates expression of V. cholerae virulence factor.

Germ-free mice were then colonized with V. cholerae and E. coli bearing either the P_(BAD)-R. obeum luxS plasmid or the vector control. Mice that received E. coli expressing R. obeum luxS showed a significantly lower level of V. cholerae colonization 8 h after gavage than mice that received E. coli with vector alone (FIG. 14B; there was no statistically significant difference in levels of E. coli between the two groups (data not shown)). Together, these results establish a direct causal relationship between R. obeum-mediated restriction of V. cholerae colonization and R. obeum Al-2 synthesis.

Several V. cholerae mutants were used to determine whether known V. cholerae Al-2 signalling pathways are required for the observed effects of R. obeum on V. cholerae colonization. LuxP is critical for sensing Al-2 in V. cholerae. Co-colonization experiments in gnotobiotic mice revealed that levels of isogenic ΔluxP or wild-type luxP⁺ V. cholerae strains were not significantly different as a function of the presence of R. obeum (FIG. 24), suggesting that R. obeum modulates V. cholerae levels through other quorum-sensing regulatory genes. The luxO and hapRgenes encode central regulators linking known V. cholerae quorum-signalling and virulence regulatory pathways. Deletion of luxO typically results in increased hapR expression¹⁵. However, our RNA-seq analysis had shown that both luxO and hapR are repressed in the presence of R. obeum (six- to sevenfold, P<0.0001; Mann-Whitney U-test), as are two important downstream activators of virulence repressed by HapR¹⁶, encoded by aphA and aphB. These findings provide additional evidence that R. obeum operates to regulate virulence through a novel regulatory pathway.

The quorum-sensing transcriptional regulator VqmA was upregulated more than 25-fold when V. cholerae was introduced into mice mono-colonized with R. obeum (FIG. 14C and Table 26). When germ-free mice were gavaged with R. obeum and a mixture of ΔvqmA (ΔlacZ)²⁷ and wild-type V. cholerae (lacZ+) strains, the ΔvqmA mutant exhibited an early competitive advantage (FIG. 14D), suggesting that R. obeum may be able to affect early colonization of V. cholerae through VqmA. VqmA is able to bind to and activate the hapR promoter directly²⁷. Since RNA-seq showed that hapR activation did not occur in gnotobiotic mice despite high levels of vqmAexpression (FIG. 24B and Table 26), we postulate that the role played by VqmA in R. obeum modulation of Vibrio virulence genes involves an uncharacterized mechanism rather than the known pathway passing through HapR.

We have identified a set of bacterial species that strongly correlate with a process in which the perturbed gut bacterial community in adult patients with cholera is restored to a configuration found in healthy Bangladeshi adults. Several of these species are also associated with the normal assembly/maturation of the gut microbiota in Bangladeshi infants and children, raising the possibility that some of these taxa may be useful for ‘repair’ of the gut microbiota in individuals whose gut communities have been ‘wounded’ through a variety of insults, including enteropathogen infections. Translating these observations to a gnotobiotic mouse model containing an artificial human gut microbiota composed of recovery- and age-indicative taxa established that one of these species, R. obeum, reduces V. cholerae colonization. As an entrenched member of the gut microbiota in Bangladeshi individuals, R. obeum could function to increase median infectious dose (ID₅₀) for V. cholerae in humans and thus help to determine whether exposure to a given dose of this enteropathogen results in diarrhoeal illness. The modest effects of R. obeum Al-2 on V. cholerae virulence gene expression in our adult gnotobiotic mouse model may reflect the possibility that we have only identified a small fraction of the microbiota's full repertoire of virulence-suppressing mechanisms. Culture collections generated from the faecal microbiota of Bangladeshi subjects are a logical starting point for ‘second-generation’ artificial communities containing R. obeum isolates that have evolved in this population, and for testing whether the observed effects of R. obeum generalize across many different strains from different populations. Moreover, the strategy described in this report could be used to mine the gut microbiota of Bangladeshi or other populations where diarrhoeal disease is endemic for additional species that use quorum-related and/or other mechanisms to limit colonization by V. cholerae and potentially other enteropathogens.

Example 11 Patient Selection

Of the 1153 patients screened (Table 18), 796 (69%) were disqualified because of immediate prior antibiotic usage. Another 100 were disqualified because their diarrhea began more than 24 h before enrollment, while 132 were excluded due to lack of a permanent address for follow-up. Of the 11 adults (all males) who entered the study, four could not be contacted by staff after discharge from the hospital; their samples were not included in our analysis, leaving a total of seven individuals (A-G; see Table 19 for clinical metadata). The seven patients included in the study experienced diarrhea for 8.0±2.6 hours (mean±SD) prior to hospital admission and for 41.5±16.7 hours during their hospital stay. They had an average of 1.5±1.0 diarrheal stools per hour (Table 19).

For ethical reasons, we could not withhold treatment with azithromycin (or for that matter oral rehydration therapy). Therefore, our study design did not allow us to isolate the nature and effect sizes of various elements of the treatment protocol on the temporal patterns of change in the gut microbiota during the acute and recovery phases of infection, versus those produced by the diarrheal disease per se.

Example 12 Identifying Community-Wide Changes in Representation of 97%-Identity OTU and Species During Diarrhea and Recovery Phases

Across all seven individuals, 58.6% of 97%-identity OTUs with a species-level taxonomic assignment associated with recovery (see below) were also detected during both diarrhea and recovery phases (FIG. 15, 16). For individuals C and E, where higher time-resolution analysis was performed, 41.1% and 29.9% of species-level taxa were identified in both diarrhea and recovery samples respectively, with 6.9% and 11.1% of the identified species detected only in recovery phase samples (see Supplementary Table 4c of Hsiao et al, Nature 2014; Epub, which is hereby incorporated by reference in its entirety).

Phylogenetic diversity (PD) of the cholera fecal microbiota decreased markedly during D-Ph2/D-Ph3, approaching the PD of healthy Bangladeshi children, before rising during R-Ph1-R-Ph3 in a temporal pattern that paralleled the UniFrac measurements of similarity to reference healthy adult controls (FIG. 19E).

Indicator species analysis was performed on the set of 236 fecal specimens selected from the diarrheal and recovery phases of subjects A-G. The statistical significance of associations was defined using permutation tests in which permutations were constrained within subjects: a bacterial species was considered significantly associated if it had a FDR-adjusted P<0.05. This approach identified 260 bacterial species consistently associated with either the diarrheal or recovery phases. 219 of these 260 species also had a significant correlation to community UniFrac distance to healthy control microbiota (FDR-adjusted P<0.05; Tables 21, 22, FIG. 16F-N). For species with positive correlations, higher relative abundances in a given microbiota state correlated to an increased difference to healthy fecal microbiota. Interpersonal differences in the distribution of 97%-identity OTUs comprising these species were also evident (FIGS. 16E, 17).

Of the 31 age-discriminatory species-level bacterial taxa in the developing gut microbiota of healthy Bangladeshi children, 24 including R. obeum and F. prausnitzii, also had a significant Spearman rank correlation value between their relative abundance in each fecal sample and the mean weighted UniFrac distance between that sample and all healthy adult Bangladeshi microbiota (Tables 21, 22, see FIGS. 16, 17, 18) for 97%-identity OTU analysis). In addition, Spearman rank correlations revealed that (i) 23 of the 27 species had relative abundances that significantly correlated with chronologic age in healthy children and with time following onset of acute diarrhea, and (ii) the direction of change (increase or decrease) was concordant between the two datasets for all 23 species (Table 20).

Example 13 Changes in Relative Abundance of Genes Encoding ECs in Fecal Microbiomes Sampled During Diarrhea and Recovery

Shotgun sequencing of DNA prepared from diarrhea and recovery phase human fecal samples, followed by binning reads into assignable KEGG Enzyme Commission numbers (ECs), revealed that genes encoding enzymes involved in carbohydrate metabolism comprised the largest category of ECs that changed in relative abundance within the fecal microbiome during the course of cholera (see FIG. 20 and Table 24 and Supplementary Table 8 of Hsiao et al, Nature 2014; Epub, which is hereby incorporated by reference in its entirety for EC-based abundance analysis, including Spearman rank correlations of EC abundance as a function of time across D-Ph1 through R-Ph3). These results led us to include Bacteroides cellulosilyticus, Bacteroides thetaiotaiotaomicron, and Clostridium scindens in the artificial community of human gut symbionts, even though they did not satisfy the criteria described above as recovery phase-indicative or significantly correlated to normal maturation of the Bangladeshi infant microbiota.

Example 14 Genome-Wide Analysis of how V. cholerae Influences the R. obeum Transcriptome In Vivo

Mice were first mono-colonized with R. obeum or V. cholerae for 7 days, followed by introduction of the other organism (FIG. 15C,D). RNA-Seq was performed using fecal samples collected from both groups of mice on the day prior to and 2 days after co-colonization (Table 28). An analysis of changes across the entire R. obeum transcriptome 2d after introduction of V. cholerae revealed few (n=7) functionally annotated transcripts with significant differences in expression (P<0.05 after multiple-hypothesis testing in DESee; see Table 26c). LuxS serves a dual role: production of the precursor Al-2 molecule [(S)-4,5-dihydroxyl-2,3-pentanedione] and participation in the pathway that re-generates homocysteine for use in the activated methyl cycle; in the absence of luxS, homocysteine is produced via oxaloacetate involving aspartate and glutamate as intermediates^(41,42) Consistent with this, three R. obeum genes encoding ECs involved in glutamate biosynthesis were significantly down-regulated after introduction of V. cholerae.

Example 15 Genome-Wide Analysis of how R. obeum Influences the V. cholerae Transcriptome In Vivo

R. obeum increased the expression of several V. cholerae genes whose functions could impact its colonization, including five that encode products involved in iron acquisition and transport [VCO365 (bacterioferritin), VCO364 (bacterioferritin-associated ferredoxin), VC0608 (iron(III) transporter), VC0750 (hesB family protein)] plus five genes thought to be involved in cell wall modification (VCO246, VCO247, VCO245, VCO259, VCO249 in Table 26b; modifications in V. cholerae LPS have been reported to be important in colonization of mice¹⁷). Cholera toxin gene (ctxA, ctxB) expression was below the limits of reliable detection in each of the V. cholerae treatment groups, consistent with previous reports that it is not required for colonization of adult mice¹¹⁻¹².

Example 16 Bile Acids and Regulation of Virulence Genes

V. cholerae senses host signals, including bile acids, in order to coordinately up-regulate expression of colonization factor genes^(13,43-47) and down-regulate expression of anti-colonization factors such as the mannose-sensitive hemagglutinin pilus⁴⁸. The gut microbiota could, in principle, affect colonization by modulating levels of host-derived signals that impact V. cholerae, or the microbiota could produce signaling molecules that directly modulate V. cholerae pathogenesis. To explore these possibilities, we used ultra-performance liquid chromatography-mass spectroscopy (UPLC-MS) to characterize the representation of bile acid species in fecal samples collected from mice colonized with the 14-member community and this community minus R. obeum, (n=5-6 animals/group). We detected 10 bile acid species, and expressed each of their levels as a proportion of the aggregate levels of all 10 bile acids. Comparing fecal samples collected from mice after colonization with the 14- and 13-member communities, we found that the presence or absence of R. obeum did not have a statistically significant effect on levels of the primary bile acids taurocholic acid, tauro-beta-muricholic acid, and beta-muricholic acid that together comprise >80% of the measured pool (P>0.05, unpaired Mann-Whitney U test). One primary bile acid, alpha muricholic acid, and a secondary bile acid, urosodeoxycholic acid, were affected, but in aggregate they represent minor constituents (<11%) of the measured pool (FIG. 22). While we could not rule out that the effect of R. obeum on these minor bile acid species impacts V. cholerae colonization/virulence, given the observed lack of change in the predominant bile acid species, we turned our attention to classes of microbial factors known to affect virulence (see Example 10).

Example 17 R. obeum Al-2 Production is Stimulated by V. cholerae In Vitro and in Co-Colonized Animals

In mice initially mono-colonized with R. obeum for 7d, R. obeum luxS expression increased more than 2-fold 2d following introduction of V. cholerae (P<0.01, unpaired Mann-Whitney U test; FIG. 21E). Using the BB170 Al-2 assay²⁴, we measured fecal Al-2 levels from mice mono-colonized with R. obeum or co-colonized with R. obeum and ΔluxS V. cholerae (MM883)¹⁴, and confirmed that Al-2 levels were modestly but significantly higher in the co-colonized group (FIG. 21F). When these bacteria were co-cultured in vitro under anaerobic conditions, R. obeum Al-2 signal increased significantly [2.8±0.1-fold (mean±SEM), P<0.01, unpaired Mann-Whitney; FIG. 21G]. Furthermore, we induced expression of cloned R. obeum and V. cholerae luxS genes using an arabinose-inducible PBAD promoter in an Al-2-deficient E. coli strain (DH5a)²⁵ and observed that supernatants from these strains were able to induce increased BB170 bioluminescence over vector controls [7.2±1.1 and 8.8±2.4-fold (mean±SEM), respectively].

Methods for Examples 10-17 Human Studies

Subject recruitment. Protocols for recruitment, enrollment, and consent, procedures for sampling the faecal microbiota of healthy Bangladeshi adults and children, and the faecal microbiota of adults during and after cholera infection, plus the subsequent de-identification of these samples, were approved by the Human Studies Committees of the International Centre for Diarrhoeal Disease Research, Bangladesh, and Washington University School of Medicine in St. Louis.

Enrollment into the adult cholera study was based on the following criteria: residency in the Dhaka Municipal Corporation area, a positive stool test for V. cholerae as judged by dark-field microscopy, diarrhoea for no more than 24 h before enrollment, and a permanent address that allowed follow-up faecal sampling after discharge from Dhaka Hospital (International Centre for Diarrhoeal Disease Research, Bangladesh). Non-prescription antibiotic usage is prevalent in Bangladesh^(28,29). Since a history of previous antibiotic consumption could be a confounder when interpreting the effects of cholera on the gut microbiota, we excluded individuals if they had received antibiotics in the 7 days preceding admission to the hospital. Since this was an observational study with no experimental treatment arm, blinding for study inclusion was not necessary. See Table 18 for the number of individuals screened for inclusion in the study, the number of potential subjects excluded from the study and the reasons for their exclusion, and the number of subjects enrolled who satisfied all criteria for inclusion.

The healthy adults were fathers in a cohort of healthy twins, triplets, and their parents living in Mirpur that is described in ref. 3. Fathers were sampled every 3 months during the first 2 years of their offspring's postnatal life. Histories of diarrhoea and antibiotic use were not available for these fathers. However, histories of diarrhoea and antibiotic use in their healthy children were known: 46 of the 49 paternal faecal samples used were obtained during periods when none of their children had diarrhoea; 36 of these 49 samples were collected at a time when there had been no antibiotic use by their children in the preceding 7 days.

DNA extraction from human faecal samples, sequencing, and analysis. All diarrhoeal stools were collected from each participant (one sterilized bowl per sample), frozen immediately at −80° C., then subjected to the same bead beating and phenol chloroform extraction procedure for DNA purification that was applied to the formed frozen faecal samples collected from these individuals during the recovery phases (and previously to a wide range of samples collected from individuals representing different ages, cultural traditions, geographical locations, and physiological and disease states^(3,30)).

DNA was isolated from all frozen faecal samples from D-Ph1 to D-Ph4, from the period of frequent sampling during the first week following discharge (recovery phase 1; R-Ph1), the period of less frequent sampling during weeks 2-3 (R-Ph2), and from weeks 4 to 12 of recovery (R-Ph3) (n=1,053 samples in total). For analyses involving healthy adult and child control groups, samples were excluded from our analysis where antibiotic use or diarrhoea was known to have occurred in the 7 days before sample collection.

For each participant in the cholera study, we selected one sample with high DNA yield (≥2 μg) from each 2-hour period during D-Ph1 to D-Ph3. An additional 7±2 samples (mean±s.d.) that had been collected during the approximately 5-h period before the rate of diarrhoea began to decrease at the beginning of D-Ph3 were included. All faecal samples collected after this time point (that is, from the remainder of D-Ph3 to R-Ph3), were also included in our analysis (n=19.7±7.4 total samples (mean±s.d.) per individual in the diarrhoeal phase, and 14±3.3 total samples per individual in the recovery phase). Two patients (C and E) were chosen for additional sequencing of all their diarrhoeal samples (n=100 and 50, respectively; see Supplementary Table 3b of Hsiao et al, Nature 2014; Epub, which is hereby incorporated by reference in its entirety).

The V4 region of bacterial 16S rRNA genes represented in each selected faecal microbiota sample was amplified by PCR using primers containing sample-specific barcode identifiers. Amplicons were purified, pooled, and paired-end sequenced with an Illumina MiSeq instrument (250 nucleotide paired-end reads; 86,315±2,043 (mean±s.e.m.) assembled reads per sample; see Supplementary Table 3 of Hsiao et al, Nature 2014; Epub, which is hereby incorporated by reference in its entirety). Healthy control samples were analysed using the same sequencing platform and chemistry (n=293 total samples).

Sequences were assembled, then de-multiplexed and analysed using the QIIME software package³¹ and custom Perl scripts. For analysis of diarrhoeal and recovery phase samples, rarefaction was performed to 49,000 reads per sample. For analyses including samples from healthy adults and children, samples were rarefied to 7,900 reads per sample. Reads sharing 97% nucleotide sequence identity were grouped into operational taxonomic units (97%-identity OTUs). To ensure that we retained less abundant bacterial taxa in our analysis of the faecal samples of patients with cholera, a 97%-identity OTU was called ‘distinct and reliable’ if it appeared at 0.1% relative abundance in at least one faecal sample. Taxonomic assignments of OTUs to species level were made using the Ribosomal Database Project version 2.4 classifier³² and a manually curated Greengenes database³³.

Indicator species analysis⁴ was used to classify bacterial species as highly associated with either diarrhoeal phases or recovery. This approach is used in studies of macroecosystems to identify species that associate with different environmental groupings; it assigns for each species an indicator value that is a product of two components: (1) the species' specificity, which is the probability that a sample in which the species is found came from a given group; and (2) the species' fidelity, which is the proportion of samples from a given group that contains the species. We performed indicator species analysis in the set of 236 faecal specimens, selected from the seven patients according to the subsampling scheme described above, to identify bacterial species consistently associated with the diarrhoeal or recovery phases across members of the study group; statistical significance was defined using permutation tests in which permutations were constrained within subjects. We also conducted a separate indicator species analysis for each subject, using each individual's replicate diarrhoeal and recovery phase samples as the groupings.

For analyses of variation across communities, we used UniFrac⁵, a metric that measures the overall degree of phylogenetic similarity of any two communities based on the degree to which they share branch length on a bacterial tree of life; low pairwise UniFrac distance values indicate that communities are more similar to one another. Unifrac distances were calculated using the QIIME software package³¹.

The gut microbiomes of study participants were characterized by paired-end 2×250 nucleotide shotgun sequencing of faecal DNA using an Illumina MiSeq instrument (mean 216,698 reads per sample; Supplementary Table 3 of Hsiao et al, Nature 2014; Epub, which is hereby incorporated by reference in its entirety). Paired sequences were assembled into single reads using the SHERA software package³⁴, and annotated by mapping to version 58 of the Kyoto Encyclopedia of Genes and Genomes (KEGG) database³⁵ using UBLAST³⁶.

Gnotobiotic Mouse Experiments.

All experiments involving animals used protocols approved by the Washington University Animal Studies Committee. Germ-free male C57BL/6J mice were maintained in flexible plastic film gnotobiotic isolators and fed an autoclaved, low-fat, plant polysaccharide-rich mouse chow (B&K, catalogue number 7378000, Zeigler Bros) ad libitum. Mice were 5-8 weeks old at time of gavage. The number of mice used in each experiment is reported in the text, relevant figure legends, and summarized in FIG. 15.

Bacterial strains and plasmids. Table 23 lists the sequenced human gut-derived bacterial strains used to generate the artificial communities and their sources. Since all Bangladeshi faecal samples were devoted to DNA extraction, we were unable to utilize strains that originated from culture collections generated from study participants' faecal biospecimens. Thus, the strains incorporated into the artificial community were from public repositories, represented multiple individuals, and were typically not accompanied by information about donor health status or living conditions.

A P_(tcp)-lux reporter strain was constructed by introducing P_(tcp)-lux (pJZ376) into V. cholerae C6706 via conjugation from SM10λpir. P_(BAD)-luxS expression vectors were produced by first amplifying the luxS sequences of V. cholerae C6706 and R. obeum ATCC2917 using PCR and the primers described in Table 29. Amplicons were then cloned into pBAD202 (TOPO TA Expression Kit; Life Technologies), and introduced into E. coli DH5a by electroporation.

All cultures of V. cholerae C6706, the isogenic ΔluxS mutant (MM883), and E. coli strains containing luxS expression vectors were grown aerobically in Luria Broth (LB) medium with appropriate antibiotics (Table 29). All members of the 14-member artificial human gut microbiota, including R. obeum ATCC29174, were propagated anaerobically in MegaMedium³⁷.

Colonization of gnotobiotic mice. All animal experiments involved administration of known consortia of bacterial species; as such, no blinding to group allocation was performed. The order of administration of microbial species to given groups of recipient mice was intentionally varied, as described in FIG. 15C-H.

Mono-colonized animals received either 200 μl of overnight cultures of R. obeum strain ATCC29174 or V. cholerae strain C6706. All V. cholerae colonization studies in mice used the current pandemic El Tor biotype (strain C6706). Mice receiving the defined 13- or 14-member communities of sequenced human bacterial symbionts were gavaged with 200 μl of an equivalent mixture of bacteria assembled from overnight monocultures of each strain (D_(600 nm)≈0.4 per strain; grown in MegaMedium). In the case of mice that received mixtures of V. cholerae and E. coli strains with R. obeum luxS-expressing plasmids (or vector controls), the E. coli strains were first grown overnight in LB medium containing 50 μg ml⁻¹ kanamycin. Two millilitres of the culture were removed and cell pellets were obtained by centrifugation, washed three times with 2 ml LB medium to remove antibiotics, and re-suspended in 6 ml LB medium containing 0.1% arabinose. The suspension of E. coli cells was then incubated at 37° C. for 90 min, and mixed with V. cholerae C6706 such that each mouse was gavaged with ˜50 μl and ˜2.5 μl of overnight cultures of each organism, respectively. All gavages involving V. cholerae were preceded by a gavage of 100 μl sterile 1 M sodium bicarbonate to neutralize gastric pH. Colonization levels of V. cholerae were determined by serial dilution plating of faecal homogenates on selective medium.

Competitive index assays were performed with mice gavaged with 50 μl aliquots of cultures of mutant and wild-type V. cholerae C6706 strains that had been grown to D_(600 nm)=0.3. For experiments involving competitive index calculations as a function of the presence of R. obeum, 100 μl of an overnight R. obeum culture was co-inoculated with the mixture of V. cholerae strains. Faecal samples from recipient gnotobiotic mice were subjected to dilution plating and aerobic growth on LB agar with the LacZ substrate Xgal; blue-white screening was used to determine colonization levels of the individual V. cholerae strains.

Community profiling by shotgun sequencing (COPRO-seq). Shotgun sequencing of faecal community DNA was used to define the relative abundance of species in the artificial communities; experimental and computational tools for COPRO-seq have been described previously⁸.

Microbial RNA-seq analysis of faecal samples collected from mice colonized with the 14-member artificial community with and without V. cholerae. Faecal samples were collected from colonized gnotobiotic mice and immediately snap-frozen in liquid nitrogen. RNA was extracted using bead-beating in phenol/chloroform/isoamyl alcohol followed by further purification using MEGACIear (Life Technologies). Purified RNA was depleted of 16S rRNA, 5S rRNA, and transfer RNA as previously described⁸ or by using a RiboZero kit (Epicentre). Complementary DNA (cDNA) libraries were generated and sequenced (50 nucleotide unidirectional reads; Illumina GA-llx, HiSeq 2000 or MiSeq instruments; see Supplementary Table 3 of Hsiao et al, Nature 2014; Epub, which is hereby incorporated by reference in its entirety). Reads were mapped to the genomes of members of the artificial community using Bowtie³⁸.

To profile transcriptional responses to V. cholerae, all cDNA reads that mapped to the genomes of the 14 consortium members were binned based on enzyme classification level annotations from KEGG. ShotgunFunctionalizeR³⁹ was then used compare the faecal meta-transcriptomes of ‘D14invasion’ animals sampled 4 days after gavage of the 14-member community to the faecal meta-transcriptomes of D1 invasion mice sampled 4 days after gavage of the 14-member community plus V. cholerae. A mean twofold or greater difference in expression between the conditions, with an adjusted P value less than 0.0001 (ShotgunFunctionalizeR) was considered significant. This approach of binning to enzyme classifications mitigates issues with low-abundance transcripts being insufficiently profiled owing to limitations in sequencing depth⁸.

Owing to the higher sequencing depth achieved for R. obeum and V. cholerae in mono- and co-colonization experiments, reads were mapped to reference genomes using Bowtie, and changes at the single transcript level were analysed using DESeq⁴⁰ (Table 27). Transcripts that satisfied the criteria of (1) having greater than twofold differential expression after DESeq normalization, (2) an adjusted P value less than 0.05, and (3) a minimum mean count value more than 10 were retained.

Al-2 assays. Previously frozen faecal pellets from gnotobiotic mice were re-suspended in AB medium²⁴ by agitation with a rotary bead-beater (25 mg faecal pellet per millilitre of medium). Al-2 assays were performed using the V. harveyi BB170 bioassay strain²⁴, with reported results representative of at least two independent experiments, each with five technical repeats. V. harveyi BB170 cultures were grown aerobically overnight in AB medium, and diluted 1:500 in this medium for use in the Al-2 bioassay²⁴. Luminescence was measured using a BioTek Synergy 2 instrument after 4 h of growth at 30° C. with agitation (300 r.p.m. using a rotatory incubator).

For in vitro measurements of R. obeum Al-2 production, a 100 μl aliquot from an overnight monoculture of the bacterium grown in MegaMedium without glucose was diluted 1:20 in fresh MegaMedium without glucose. In addition, cells pelleted from 100 μl of an overnight culture of V. cholerae ΔluxS (MM883 (ref. 14)) grown in LB medium were added to R. obeum that had also been diluted 1:20 in MegaMedium without glucose. The resulting mono- and co-cultures were incubated anaerobically at 37° C. for 16 h. Cells were pelleted by centrifugation, and supernatants were harvested and then added to V. harveyi BB170 cultures for Al-2 bioassay.

UPLC-MS. Procedures for UPLC-MS of bile acids have been described in ref. 37.

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TABLE 1 Metadata for 50 healthy Bangladeshi children sampled monthly during the first two years of life. Child ID Family ID Birth Cohort Gender Zygosity WHZ WAZ HAZ Bgsng7035 Bgsng7035 Healthy Singleton Birth Cohort Male NA −0.5 ± 0.5 −1.7 ± 0.2 −1.7 ± 0.2 Bgsng7106 Bgsng7106 Healthy Singleton Birth Cohort Male NA −0.4 ± 0.6 −0.9 ± 0.9 −0.9 ± 0.9 Bgsng7115 Bgsng7115 Healthy Singleton Birth Cohort Male NA −1.6 ± 0.5  0.2 ± 0.4  0.2 ± 0.4 Bgsng7128 Bgsng7128 Healthy Singleton Birth Cohort Female NA −1.4 ± 0.7 −1.3 ± 0.6 −1.3 ± 0.6 Bgsng7150 Bgsng7150 Healthy Singleton Birth Cohort Male NA  0.0 ± 1.2  0.0 ± 0.8  0.0 ± 0.8 Bgsng7155 Bgsng7155 Healthy Singleton Birth Cohort Female NA −1.5 ± 1.3 −1.0 ± 1.3 −1.0 ± 1.3 Bgsng7177 Bgsng7177 Healthy Singleton Birth Cohort Female NA  0.9 ± 0.6 −0.9 ± 1.0 −0.9 ± 1.0 Bgsng7192 Bgsng7192 Healthy Singleton Birth Cohort Female NA  0.0 ± 0.8 −1.6 ± 0.7 −1.6 ± 0.7 Bgsng7202 Bgsng7202 Healthy Singleton Birth Cohort Female NA −0.4 ± 1.8  0.1 ± 0.6  0.1 ± 0.6 Bgsng7204 Bgsng7204 Healthy Singleton Birth Cohort Male NA −0.7 ± 1.7 −0.1 ± 0.6 −0.1 ± 0.6 Bgsng8064 Bgsng8064 Healthy Singleton Birth Cohort Male NA  0.9 ± 0.7  1.7 ± 0.7  1.7 ± 0.7 Bgsng8169 Bgsng8169 Healthy Singleton Birth Cohort Male NA  0.9 ± 1.5  1.1 ± 0.5  1.1 ± 0.5 Bgsng7018 Bgsng7018 Healthy Singleton Birth Cohort Male NA −0.7 ± 0.7 −0.4 ± 0.9 −0.4 ± 0.9 Bgsng7052 Bgsng7052 Healthy Singleton Birth Cohort Male NA  0.0 ± 1.1 −0.3 ± 1.2 −0.3 ± 1.2 Bgsng7063 Bgsng7063 Healthy Singleton Birth Cohort Male NA −0.4 ± 0.7  0.0 ± 0.9  0.0 ± 0.9 Bgsng7071 Bgsng7071 Healthy Singleton Birth Cohort Male NA  0.5 ± 0.8  0.6 ± 0.7  0.6 ± 0.7 Bgsng7082 Bgsng7082 Healthy Singleton Birth Cohort Female NA −0.9 ± 1.4 −0.8 ± 0.7 −0.8 ± 0.7 Bgsng7090 Bgsng7090 Healthy Singleton Birth Cohort Male NA −0.4 ± 0.5 −0.3 ± 0.7 −0.3 ± 0.7 Bgsng7096 Bgsng7096 Healthy Singleton Birth Cohort Female NA −0.5 ± 0.4 −1.1 ± 0.6 −1.1 ± 0.6 Bgsng7114 Bgsng7114 Healthy Singleton Birth Cohort Male NA −0.9 ± 0.3 −0.7 ± 0.2 −0.7 ± 0.2 Bgsng7131 Bgsng7131 Healthy Singleton Birth Cohort Male NA −0.9 ± 0.5 −1.3 ± 0.8 −1.3 ± 0.8 Bgsng7142 Bgsng7142 Healthy Singleton Birth Cohort Male NA −0.7 ± 1.5 −0.8 ± 1.5 −0.8 ± 1.5 Bgsng7149 Bgsng7149 Healthy Singleton Birth Cohort Female NA −1.0 ± 0.4 −0.3 ± 0.4 −0.3 ± 0.4 Bgsng7173 Bgsng7173 Healthy Singleton Birth Cohort Male NA −0.5 ± 0.5 −1.2 ± 0.6 −1.2 ± 0.6 Bgsng7178 Bgsng7178 Healthy Singleton Birth Cohort Female NA  0.6 ± 1.4 −0.9 ± 0.6 −0.9 ± 0.6 Bgtw1.T1 Bgtw1 Healthy Twins & Triplets Female MZ −0.5 ± 0.7 −2.3 ± 0.5 −3.1 ± 0.7 Bgtw1.T2 Bgtw1 Healthy Twins & Triplets Female MZ −1.3 ± 0.8 −3.0 ± 0.3 −3.4 ± 0.7 Bgtw2.T1 Bgtw2 Healthy Twins & Triplets Male DZ −1.2 ± 0.8 −3.8 ± 0.9 −4.7 ± 0.7 Bgtw2.T2 Bgtw2 Healthy Twins & Triplets Female DZ −0.8 ± 1.0 −3.3 ± 0.9 −4.2 ± 0.4 Bgtw3.T1 Bgtw3 Healthy Twins & Triplets Male MZ −0.6 ± 0.4 −1.4 ± 0.5 −1.6 ± 0.3 Bgtw3.T2 Bgtw3 Healthy Twins & Triplets Male MZ −0.6 ± 0.5 −1.8 ± 0.6 −2.1 ± 0.6 Bgtw4.T1 Bgtw4 Healthy Twins & Triplets Female MZ co-twin in −0.2 ± 0.8 −2.4 ± 0.6 −3.4 ± 0.5 set of triplets Bgtw4.T2 Bgtw4 Healthy Twins & Triplets Female MZ co-twin in −0.1 ± 0.8 −2.2 ± 0.9 −3.4 ± 0.6 set of triplets Bgtw4.T3 Bgtw4 Healthy Twins & Triplets Female Fraternal co-twin −1.7 ± 0.9 −2.9 ± 0.7 −2.6 ± 0.6 in set of triplets Bgtw5.T1 Bgtw5 Healthy Twins & Triplets Male DZ −0.5 ± 0.8 −3.1 ± 0.9 −4.3 ± 0.8 Bgtw5.T2 Bgtw5 Healthy Twins & Triplets Female DZ −0.1 ± 0.5 −2.5 ± 0.4 −4.0 ± 0.5 Bgtw6.T1 Bgtw6 Healthy Twins & Triplets Male DZ −0.2 ± 0.6 −1.5 ± 1.8 −1.6 ± 1.7 Bgtw6.T2 Bgtw6 Healthy Twins & Triplets Male DZ −0.6 ± 0.6 −2.5 ± 1.2 −2.6 ± 1.7 Bgtw7.T1 Bgtw7 Healthy Twins & Triplets Female DZ  0.5 ± 1.0 −2.3 ± 0.5 −3.8 ± 0.4 Bgtw7.T2 Bgtw7 Healthy Twins & Triplets Female DZ  0.5 ± 1.7 −2.8 ± 0.8 −4.3 ± 0.2 Bgtw8.T1 Bgtw8 Healthy Twins & Triplets Female DZ −0.9 ± 0.7 −1.6 ± 0.3 −1.4 ± 0.4 Bgtw8.T2 Bgtw8 Healthy Twins & Triplets Female DZ −1.4 ± 0.8 −2.6 ± 0.5 −2.3 ± 0.6 Bgtw9.T1 Bgtw9 Healthy Twins & Triplets Female MZ  0.1 ± 1.2 −3.1 ± 0.5 −4.0 ± 0.7 Bgtw9.T2 Bgtw9 Healthy Twins & Triplets Female MZ  0.8 ± 1.2 −2.6 ± 0.6 −4.0 ± 0.9 Bgtw10.T1 Bgtw10 Healthy Twins & Triplets Female MZ −1.5 ± 0.8 −2.7 ± 0.5 −2.4 ± 0.4 Bgtw10.T2 Bgtw10 Healthy Twins & Triplets Female MZ −1.0 ± 1.1 −2.8 ± 0.3 −2.8 ± 0.5 Bgtw11.T1 Bgtw11 Healthy Twins & Triplets Female not tested −0.2 ± 0.3 −2.9 ± 0.4 −3.7 ± 0.4 Bgtw11.T2 Bgtw11 Healthy Twins & Triplets Female not tested −0.7 ± 0.9 −2.6 ± 0.4 −2.9 ± 0.3 Bgtw12.T1 Bgtw12 Healthy Twins & Triplets Male DZ  1.2 ± 1.3 −2.3 ± 1.1 −4.4 ± 1.2 Bgtw12.T2 Bgtw12 Healthy Twins & Triplets Female DZ −0.6 ± 2.0 −2.9 ± 1.2 −3.6 ± 0.9 Fraction of samples collected where Age at Age at Sampling % Days with antibiotics first fecal last fecal Number interval Months of Age at first diarrhoea had been Training- sample sample of fecal (days) exclusive introduction Number of during consumed Validation collection collection samples mean ± breast- of solid diarrhoeal sampling within prior Set Subject Child ID (days) (days) collected SD feeding food (months) episodes/yr period 7 days Allocation Bgsng7035 5 701 23 32 ± 11 0.0 1.2 3.6 1.9 0.2 Training Bgsng7106 9 738 19 41 ± 19 4.4 9.4 4.0 3.9 0.1 Training Bgsng7115 5 706 21 35 ± 19 0.9 6.2 5.2 5.9 0.1 Training Bgsng7128 4 735 23 33 ± 12 3.3 9.8 4.5 5.0 0.1 Training Bgsng7150 5 701 22 33 ± 14 5.9 8.2 2.1 3.0 0.4 Training Bgsng7155 5 701 24 30 ± 5  1.2 4.3 1.6 1.6 0.3 Training Bgsng7177 8 700 23 31 ± 6  6.4 7.3 3.7 4.3 0.2 Training Bgsng7192 4 704 24 30 ± 8  5.4 6.3 5.2 4.4 0.4 Training Bgsng7202 6 714 23 32 ± 11 5.4 6.2 3.1 3.1 0.1 Training Bgsng7204 5 708 24 31 ± 10 0.2 4.5 8.8 7.2 0.4 Training Bgsng8064 6 700 24 30 ± 4  3.0 6.0 3.1 3.6 0.1 Training Bgsng8169 6 737 22 35 ± 18 3.0 5.6 3.0 2.3 0.0 Training Bgsng7018 3 710 21 35 ± 24 7.3 9.6 4.6 3.5 0.3 Validation Bgsng7052 7 715 20 37 ± 22 6.6 7.3 4.1 4.8 0.1 Validation Bgsng7063 5 700 20 37 ± 17 0.2 9.2 2.1 1.6 0.0 Validation Bgsng7071 4 704 18 41 ± 11 6.3 8.4 8.8 8.0 0.3 Validation Bgsng7082 5 724 18 42 ± 28 4.4 5.8 3.5 3.0 0.3 Validation Bgsng7090 5 703 23 32 ± 12 3.4 4.7 7.3 5.1 0.4 Validation Bgsng7096 15 706 23 31 ± 10 3.2 7.2 2.6 2.7 0.2 Validation Bgsng7114 4 702 18 41 ± 18 3.1 4.3 0.5 0.1 0.0 Validation Bgsng7131 10 717 23 32 ± 10 2.2 3.1 4.1 4.3 0.3 Validation Bgsng7142 12 728 22 34 ± 13 0.4 4.6 3.0 4.1 0.3 Validation Bgsng7149 5 704 22 33 ± 11 3.4 9.4 6.2 3.7 0.2 Validation Bgsng7173 8 702 24 30 ± 9  1.6 4.0 7.8 10.8 0.5 Validation Bgsng7178 8 700 24 30 ± 6  5.3 6.3 4.7 4.3 0.3 Validation Bgtw1.T1 35 730 26 28 ± 7  0.0 4.1 2.0 2.7 0.4 Validation - Twins & Triplets Bgtw1.T2 34 729 24 30 ± 9  0.0 4.1 2.0 2.7 0.3 Validation - Twins & Triplets Bgtw2.T1 31 701 25 28 ± 8  1.0 3.1 0.5 0.7 0.1 Validation - Twins & Triplets Bgtw2.T2 31 701 25 28 ± 7  2.0 7.9 1.0 1.0 0.1 Validation - Twins & Triplets Bgtw3.T1 8 638 24 27 ± 12 0.0 7.1 2.9 5.0 0.0 Validation - Twins & Triplets Bgtw3.T2 8 639 26 25 ± 12 0.0 7.9 1.7 4.7 0.1 Validation - Twins & Triplets Bgtw4.T1 1 575 21 29 ± 10 0.0 9.1 1.3 0.3 0.1 Validation - Twins & Triplets Bgtw4.T2 1 581 19 32 ± 7  0.0 8.9 1.9 0.7 0.1 Validation - Twins & Triplets Bgtw4.T3 7 575 22 27 ± 9  0.0 8.9 3.8 3.8 0.1 Validation - Twins & Triplets Bgtw5.T1 31 638 21 30 ± 3  1.0 8.0 0.6 0.2 0.0 Validation - Twins & Triplets Bgtw5.T2 4 638 21 32 ± 7  0.1 7.0 1.7 1.1 0.0 Validation - Twins & Triplets Bgtw6.T1 6 286 9 35 ± 25 0.2 7.9 1.3 1.7 0.1 Validation - Twins & Triplets Bgtw6.T2 6 286 10 35 ± 11 0.2 9.4 0.0 0.3 0.1 Validation - Twins & Triplets Bgtw7.T1 14 455 18 26 ± 8  0.0 9.0 0.8 0.4 0.2 Validation - Twins & Triplets Bgtw7.T2 12 455 18 26 ± 7  0.4 9.1 3.2 2.0 0.2 Validation - Twins & Triplets Bgtw8.T1 15 364 14 27 ± 8  1.0 6.1 1.0 1.9 0.2 Validation - Twins & Triplets Bgtw8.T2 15 366 13 29 ± 5  1.0 6.1 0.0 0.0 0.5 Validation - Twins & Triplets Bgtw9.T1 37 368 12 30 ± 3  2.1 6.9 3.0 1.4 0.3 Validation - Twins & Triplets Bgtw9.T2 8 368 14 28 ± 7  2.3 6.9 2.0 2.2 0.1 Validation - Twins & Triplets Bgtw10.T1 4 366 17 23 ± 10 1.0 6.9 5.0 9.6 0.1 Validation - Twins & Triplets Bgtw10.T2 4 365 17 23 ± 11 1.1 6.9 4.0 9.3 0.1 Validation - Twins & Triplets Bgtw11.T1 1 336 12 30 ± 5  0.9 3.9 0.0 0.0 0.1 Validation - Twins & Triplets Bgtw11.T2 5 368 13 30 ± 11 1.1 4.0 0.0 0.0 0.0 Validation - Twins & Triplets Bgtw12.T1 6 372 14 28 ± 6  1.0 8.5 1.0 1.6 0.4 Validation - Twins & Triplets Bgtw12.T2 6 372 13 31 ± 5  1.0 8.0 1.0 0.5 0.1 Validation - Twins & Triplets NA, not applicable

TABLE 2 Information associated with fecal samples collected from parents in twins and triplets birth cohort Age of subject Age of subject's Age of subject's at time of children at the children at the Number of fecal sample time of subject's time of subject's high quality Person Family Fecal Sample collection, fecal sample fecal sample V4-16S rRNA 16S rRNA Family ID ID membership ID years collection, months collection, days sequences Sequencing Run ID Bgtw1 Bgtw1.F Father Bgtw1.F.m1 33.0 1 5 17,266 TCP2 (runs 1 and 2) Bgtw1 Bgtw1.F Father Bgtw1.F.m4 33.3 4 93 13,599 T12 Bgtw1 Bgtw1.F Father Bgtw1.F.m7 33.5 7 184 18,411 T12 Bgtw1 Bgtw1.F Father Bgtw1.F.m10 33.8 10 274 18,354 T12 Bgtw1 Bgtw1.F Father Bgtw1.F.m12 34.0 12 369 33,506 T12 Bgtw1 Bgtw1.F Father Bgtw1.F.m16 34.3 16 459 22,406 T12 Bgtw2 Bgtw2.F Father Bgtw2.F.m4 26.3 4 95 14,837 T34 Bgtw2 Bgtw2.F Father Bgtw2.F.m10 26.5 10 276 9,185 T34 Bgtw3 Bgtw3.F Father Bgtw3.F.m1 40.0 1 8 11,154 T12 Bgtw3 Bgtw3.F Father Bgtw3.F.m4 40.3 4 92 10,854 T34 Bgtw3 Bgtw3.F Father Bgtw3.F.m7 40.5 7 179 34,147 T78 Bgtw3 Bgtw3.F Father Bgtw3.F.m10 40.8 10 274 15,316 TCP2 (runs 1 and 2) Bgtw3 Bgtw3.F Father Bgtw3.F.m13 41.0 13 367 22,178 T12 Bgtw3 Bgtw3.F Father Bgtw3.F.m16 41.3 16 458 30,845 TCP2 (runs 1 and 2) Bgtw4 Bgtw4.F Father Bgtw4.F.m1 23.0 1 5 27,558 T12 Bgtw4 Bgtw4.F Father Bgtw4.F.m4 23.3 4 92 18,137 T34 Bgtw4 Bgtw4.F Father Bgtw4.F.m7 23.5 7 187 18,674 T34 Bgtw4 Bgtw4.F Father Bgtw4.F.m10 23.8 10 272 23,417 T56 (runs 1 and 2) Bgtw4 Bgtw4.F Father Bgtw4.F.m13 24.0 13 365 23,890 T56 (runs 1 and 2) Bgtw5 Bgtw5.F Father Bgtw5.F.m1 38.0 1 4 18,085 T12 Bgtw5 Bgtw5.F Father Bgtw5.F.m4 38.3 4 94 25,138 T56 (runs 1 and 2) Bgtw5 Bgtw5.F Father Bgtw5.F.m7 38.5 7 195 14,529 T34 Bgtw5 Bgtw5.F Father Bgtw5.F.m10 38.8 10 274 15,468 T12 Bgtw5 Bgtw5.F Father Bgtw5.F.m13 39.0 13 366 17,789 T34 Bgtw6 Bgtw6.F Father Bgtw6.F.m1 29.0 1 2 14,873 T34 Bgtw6 Bgtw6.F Father Bgtw6.F.m4 29.3 4 92 19,520 TCP2 (runs 1 and 2) Bgtw6 Bgtw6.F Father Bgtw6.F.m7 29.5 7 181 16,345 TCP2 (runs 1 and 2) Bgtw6 Bgtw6.F Father Bgtw6.F.m10 29.8 10 286 9,139 T12 Bgtw7 Bgtw7.F Father Bgtw7.F.m1 38.0 1 14 21,791 T34 Bgtw7 Bgtw7.F Father Bgtw7.F.m4 38.3 4 91 12,730 TCP2 (runs 1 and 2) Bgtw7 Bgtw7.F Father Bgtw7.F.m7 38.5 7 190 13,123 T12 Bgtw8 Bgtw8.F Father Bgtw8.F.m1 40.0 1 18 14,289 TCP2 (runs 1 and 2) Bgtw8 Bgtw8.F Father Bgtw8.F.m4 40.3 4 92 18,075 TCP2 (runs 1 and 2) Bgtw8 Bgtw8.F Father Bgtw8.F.m7 40.5 7 185 29,674 TCP2 (runs 1 and 2) Bgtw8 Bgtw8.F Father Bgtw8.F.m13 41.0 13 374 29,593 TCP2 (runs 1 and 2) Bgtw9 Bgtw9.F Father Bgtw9.F.m1 28.0 1 8 16,769 T34 Bgtw9 Bgtw9.F Father Bgtw9.F.m4 28.3 4 93 8,311 T12 Bgtw9 Bgtw9.F Father Bgtw9.F.m7 28.5 7 185 25,311 T56 (runs 1 and 2) Bgtw9 Bgtw9.F Father Bgtw9.F.m10 28.8 10 278 20,809 T56 (runs 1 and 2) Bgtw9 Bgtw9.F Father Bgtw9.F.m13 29.0 13 367 26,044 T56 (runs 1 and 2) Bgtw10 Bgtw10.F Father Bgtw10.F.m1 32.0 1 2 20,923 T12 Bgtw10 Bgtw10.F Father Bgtw10.F.m4 32.3 4 92 14,148 T34 Bgtw10 Bgtw10.F Father Bgtw10.F.m7 32.5 7 191 14,161 TCP2 (runs 1 and 2) Bgtw10 Bgtw10.F Father Bgtw10.F.m10 32.8 10 275 25,813 T56 (runs 1 and 2) Bgtw10 Bgtw10.F Father Bgtw10.F.m13 33.0 13 365 38,175 T56 (runs 1 and 2) Bgtw11 Bgtw11.F Father Bgtw11.F.m1 26.0 1 4 23,237 TCP2 (runs 1 and 2) Bgtw11 Bgtw11.F Father Bgtw11.F.m4 26.3 4 88 28,777 T56 (runs 1 and 2) Bgtw12 Bgtw12.F Father Bgtw12.F.m1 25.0 1 7 23,115 TCP2 (runs 1 and 2) Bgtw12 Bgtw12.F Father Bgtw12.F.m4 25.3 4 94 22,396 T56 (runs 1 and 2) Bgtw1 Bgtw1.M Mother Bgtw1.M.m1 25.0 1 5 12,057 T34 Bgtw1 Bgtw1.M Mother Bgtw1.M.m3 25.2 3 64 15,500 T34 Bgtw1 Bgtw1.M Mother Bgtw1.M.m4 25.3 4 92 22,699 T34 Bgtw1 Bgtw1.M Mother Bgtw1.M.m5 25.3 5 124 14,512 T34 Bgtw1 Bgtw1.M Mother Bgtw1.M.m6 25.5 6 167 15,921 T34 Bgtw1 Bgtw1.M Mother Bgtw1.M.m7 25.5 7 188 19,137 T12 Bgtw1 Bgtw1.M Mother Bgtw1.M.m8 25.6 8 216 37,309 T56 (runs 1 and 2) Bgtw1 Bgtw1.M Mother Bgtw1.M.m9 25.7 9 243 18,428 T34 Bgtw1 Bgtw1.M Mother Bgtw1.M.m10 25.8 10 274 15,102 T34 Bgtw1 Bgtw1.M Mother Bgtw1.M.m11 25.8 11 305 13,393 T34 Bgtw1 Bgtw1.M Mother Bgtw1.M.m12 25.9 12 338 19,050 T34 Bgtw1 Bgtw1.M Mother Bgtw1.M.m13 26.0 13 365 19,374 T12 Bgtw1 Bgtw1.M Mother Bgtw1.M.m14 26.1 14 397 19,439 T12 Bgtw1 Bgtw1.M Mother Bgtw1.M.m15 26.2 15 426 22,949 TCP2 (runs 1 and 2) Bgtw1 Bgtw1.M Mother Bgtw1.M.m16 26.2 16 456 10,227 T12 Bgtw1 Bgtw1.M Mother Bgtw1.M.m17 26.3 17 488 23,442 T12 Bgtw1 Bgtw1.M Mother Bgtw1.M.m18 26.4 18 519 18,496 T12 Bgtw1 Bgtw1.M Mother Bgtw1.M.m19 26.5 19 551 18,563 T78 Bgtw1 Bgtw1.M Mother Bgtw1.M.m20 26.6 20 579 20,085 T78 Bgtw1 Bgtw1.M Mother Bgtw1.M.m21 26.7 21 610 18,046 T78 Bgtw1 Bgtw1.M Mother Bgtw1.M.m22 26.8 22 639 16,539 T78 Bgtw1 Bgtw1.M Mother Bgtw1.M.m23 26.8 23 669 14,823 T78 Bgtw1 Bgtw1.M Mother Bgtw1.M.m24 26.9 24 700 15,480 T56 (runs 1 and 2) Bgtw1 Bgtw1.M Mother Bgtw1.M.m25 27.0 25 730 35,842 T56 (runs 1 and 2) Bgtw2 Bgtw2.M Mother Bgtw2.M.m1 22.0 1 1 14,645 TRX Bgtw2 Bgtw2.M Mother Bgtw2.M.m2 22.1 2 31 20,841 T34 Bgtw2 Bgtw2.M Mother Bgtw2.M.m3 22.2 3 60 15,540 T12 Bgtw2 Bgtw2.M Mother Bgtw2.M.m4 22.3 4 94 12,088 T12 Bgtw2 Bgtw2.M Mother Bgtw2.M.m5 22.3 5 123 17,342 T34 Bgtw2 Bgtw2.M Mother Bgtw2.M.m6 22.4 6 154 12,497 T34 Bgtw2 Bgtw2.M Mother Bgtw2.M.m7 22.5 7 184 33,721 T56 (runs 1 and 2) Bgtw2 Bgtw2.M Mother Bgtw2.M.m8 22.6 8 214 13,669 T34 Bgtw2 Bgtw2.M Mother Bgtw2.M.m9 22.7 9 240 35,256 T56 (runs 1 and 2) Bgtw2 Bgtw2.M Mother Bgtw2.M.m10 22.8 10 275 14,594 T34 Bgtw2 Bgtw2.M Mother Bgtw2.M.m11 22.8 11 302 13,499 T34 Bgtw2 Bgtw2.M Mother Bgtw2.M.m12 22.9 12 333 13,956 T34 Bgtw2 Bgtw2.M Mother Bgtw2.M.m13 23.0 13 367 11,822 T34 Bgtw2 Bgtw2.M Mother Bgtw2.M.m14 23.1 14 399 14,283 T34 Bgtw2 Bgtw2.M Mother Bgtw2.M.m15 23.2 15 426 21,608 T12 Bgtw2 Bgtw2.M Mother Bgtw2.M.m16 23.3 16 458 20,707 T34 Bgtw2 Bgtw2.M Mother Bgtw2.M.m17 23.3 17 491 21,304 T56 (runs 1 and 2) Bgtw2 Bgtw2.M Mother Bgtw2.M.m18 23.4 18 518 18,054 TCP2 (runs 1 and 2) Bgtw2 Bgtw2.M Mother Bgtw2.M.m19 23.5 19 547 21,550 T56 (runs 1 and 2) Bgtw2 Bgtw2.M Mother Bgtw2.M.m20 23.6 20 581 24,239 T56 (runs 1 and 2) Bgtw2 Bgtw2.M Mother Bgtw2.M.m21 23.7 21 609 18,456 T78 Bgtw2 Bgtw2.M Mother Bgtw2.M.m22 23.8 22 639 23,139 T56 (runs 1 and 2) Bgtw2 Bgtw2.M Mother Bgtw2.M.m23 23.8 23 668 18,401 T78 Bgtw2 Bgtw2.M Mother Bgtw2.M.m24 23.9 24 702 22,541 T56 (runs 1 and 2) Bgtw3 Bgtw3.M Mother Bgtw3.M.m1 30.0 1 8 18,168 T56 (runs 1 and 2) Bgtw3 Bgtw3.M Mother Bgtw3.M.m2 30.1 2 32 15,001 T34 Bgtw3 Bgtw3.M Mother Bgtw3.M.m3 30.2 3 61 12,832 T34 Bgtw3 Bgtw3.M Mother Bgtw3.M.m4 30.3 4 92 15,985 T34 Bgtw3 Bgtw3.M Mother Bgtw3.M.m5 30.3 5 123 17,652 T34 Bgtw3 Bgtw3.M Mother Bgtw3.M.m6 30.4 6 151 17,953 TCP2 (runs 1 and 2) Bgtw3 Bgtw3.M Mother Bgtw3.M.m7 30.5 7 178 17,506 T34 Bgtw3 Bgtw3.M Mother Bgtw3.M.m8 30.6 8 213 7,341 T12 Bgtw3 Bgtw3.M Mother Bgtw3.M.m9 30.7 9 240 16,599 T34 Bgtw3 Bgtw3.M Mother Bgtw3.M.m10 30.8 10 274 24,901 T56 (runs 1 and 2) Bgtw3 Bgtw3.M Mother Bgtw3.M.m11 30.8 11 304 19,920 T34 Bgtw3 Bgtw3.M Mother Bgtw3.M.m12 30.9 12 341 15,278 TCP2 (runs 1 and 2) Bgtw3 Bgtw3.M Mother Bgtw3.M.m13 31.0 13 367 30,379 TCP2 (runs 1 and 2) Bgtw3 Bgtw3.M Mother Bgtw3.M.m14 31.1 14 400 26,537 TCP2 (runs 1 and 2) Bgtw3 Bgtw3.M Mother Bgtw3.M.m15 31.2 15 430 14,244 T12 Bgtw3 Bgtw3.M Mother Bgtw3.M.m16 31.3 16 459 22,655 T12 Bgtw3 Bgtw3.M Mother Bgtw3.M.m17 31.3 17 487 32,562 T56 (runs 1 and 2) Bgtw3 Bgtw3.M Mother Bgtw3.M.m19 31.5 19 549 29,619 T56 (runs 1 and 2) Bgtw3 Bgtw3.M Mother Bgtw3.M.m20 31.6 20 579 15,865 TCP2 (runs 1 and 2) Bgtw3 Bgtw3.M Mother Bgtw3.M.m21 31.7 21 609 17,611 TCP2 (runs 1 and 2) Bgtw3 Bgtw3.M Mother Bgtw3.M.m22 31.7 22 638 15,611 TCP2 (runs 1 and 2) Bgtw4 Bgtw4.M Mother Bgtw4.M.m1 20.0 1 5 20,006 T34 Bgtw4 Bgtw4.M Mother Bgtw4.M.m2 20.1 2 32 16,042 T34 Bgtw4 Bgtw4.M Mother Bgtw4.M.m3 20.2 3 61 15,325 T34 Bgtw4 Bgtw4.M Mother Bgtw4.M.m4 20.3 4 92 22,921 T12 Bgtw4 Bgtw4.M Mother Bgtw4.M.m5 20.3 5 123 13,727 T34 Bgtw4 Bgtw4.M Mother Bgtw4.M.m6 20.4 6 151 25,198 T56 (runs 1 and 2) Bgtw4 Bgtw4.M Mother Bgtw4.M.m7 20.5 7 181 20,259 T34 Bgtw4 Bgtw4.M Mother Bgtw4.M.m8 20.6 8 211 15,493 T34 Bgtw4 Bgtw4.M Mother Bgtw4.M.m9 20.7 9 251 14,538 T34 Bgtw4 Bgtw4.M Mother Bgtw4.M.m10 20.8 10 277 16,851 T34 Bgtw4 Bgtw4.M Mother Bgtw4.M.m11 20.8 11 305 11,467 T34 Bgtw4 Bgtw4.M Mother Bgtw4.M.m12 20.9 12 334 32,997 T56 (runs 1 and 2) Bgtw4 Bgtw4.M Mother Bgtw4.M.m13 21.0 13 364 20,722 T12 Bgtw4 Bgtw4.M Mother Bgtw4.M.m14 21.1 14 395 13,616 T12 Bgtw4 Bgtw4.M Mother Bgtw4.M.m15 21.2 15 425 21,943 T12 Bgtw4 Bgtw4.M Mother Bgtw4.M.m16 21.3 16 458 22,991 T78 Bgtw4 Bgtw4.M Mother Bgtw4.M.m17 21.3 17 487 17,381 T78 Bgtw4 Bgtw4.M Mother Bgtw4.M.m18 21.4 18 517 34,752 T56 (runs 1 and 2) Bgtw4 Bgtw4.M Mother Bgtw4.M.m19 21.5 19 547 24,521 T56 (runs 1 and 2) Bgtw4 Bgtw4.M Mother Bgtw4.M.m20 21.6 20 575 44,125 T56 (runs 1 and 2) Bgtw5 Bgtw5.M Mother Bgtw5.M.m1 29.0 1 4 9,540 T34 Bgtw5 Bgtw5.M Mother Bgtw5.M.m2 29.1 2 33 16,280 T34 Bgtw5 Bgtw5.M Mother Bgtw5.M.m3 29.2 3 61 23,552 TCP2 (runs 1 and 2) Bgtw5 Bgtw5.M Mother Bgtw5.M.m4 29.3 4 95 25,903 T12 Bgtw5 Bgtw5.M Mother Bgtw5.M.m5 29.3 5 123 15,880 T34 Bgtw5 Bgtw5.M Mother Bgtw5.M.m6 29.4 6 152 16,214 T34 Bgtw5 Bgtw5.M Mother Bgtw5.M.m7 29.5 7 181 20,984 T56 (runs 1 and 2) Bgtw5 Bgtw5.M Mother Bgtw5.M.m8 29.6 8 218 13,008 T34 Bgtw5 Bgtw5.M Mother Bgtw5.M.m9 29.7 9 248 21,653 T34 Bgtw5 Bgtw5.M Mother Bgtw5.M.m10 29.8 10 277 13,582 T34 Bgtw5 Bgtw5.M Mother Bgtw5.M.m11 29.8 11 310 14,621 T12 Bgtw5 Bgtw5.M Mother Bgtw5.M.m12 29.9 12 341 18,744 T34 Bgtw5 Bgtw5.M Mother Bgtw5.M.m13 30.0 13 365 15,753 T34 Bgtw5 Bgtw5.M Mother Bgtw5.M.m14 30.1 14 396 21,882 T56 (runs 1 and 2) Bgtw5 Bgtw5.M Mother Bgtw5.M.m15 30.2 15 429 17,027 T12 Bgtw5 Bgtw5.M Mother Bgtw5.M.m16 30.3 16 458 14,496 T78 Bgtw5 Bgtw5.M Mother Bgtw5.M.m17 30.4 17 493 14,010 T78 Bgtw5 Bgtw5.M Mother Bgtw5.M.m18 30.4 18 514 18,506 T78 Bgtw5 Bgtw5.M Mother Bgtw5.M.m19 30.5 19 548 19,202 T56 (runs 1 and 2) Bgtw5 Bgtw5.M Mother Bgtw5.M.m20 30.6 20 578 22,358 T56 (runs 1 and 2) Bgtw5 Bgtw5.M Mother Bgtw5.M.m21 30.7 21 613 41,854 T56 (runs 1 and 2) Bgtw5 Bgtw5.M Mother Bgtw5.M.m22 30.8 22 640 14,899 T78 Bgtw6 Bgtw6.M Mother Bgtw6.M.m1 18.0 1 6 21,134 T12 Bgtw6 Bgtw6.M Mother Bgtw6.M.m2 18.1 2 35 22,561 TCP2 (runs 1 and 2) Bgtw6 Bgtw6.M Mother Bgtw6.M.m3 18.2 3 63 12,071 TCP2 (runs 1 and 2) Bgtw6 Bgtw6.M Mother Bgtw6.M.m4 18.3 4 92 15,084 T12 Bgtw6 Bgtw6.M Mother Bgtw6.M.m6 18.4 6 152 8,105 T12 Bgtw6 Bgtw6.M Mother Bgtw6.M.m7 18.5 7 182 24,708 TCP2 (runs 1 and 2) Bgtw6 Bgtw6.M Mother Bgtw6.M.m8 18.6 8 212 25,775 T56 (runs 1 and 2) Bgtw6 Bgtw6.M Mother Bgtw6.M.m9 18.7 9 246 31,301 TCP2 (runs 1 and 2) Bgtw6 Bgtw6.M Mother Bgtw6.M.m10 18.8 10 286 22,264 TCP2 (runs 1 and 2) Bgtw7 Bgtw7.M Mother Bgtw7.M.m1 32.0 1 12 12,620 T34 Bgtw7 Bgtw7.M Mother Bgtw7.M.m2 32.1 2 32 12,895 T34 Bgtw7 Bgtw7.M Mother Bgtw7.M.m3 32.2 3 61 14,622 T34 Bgtw7 Bgtw7.M Mother Bgtw7.M.m4 32.2 4 90 15,904 T12 Bgtw7 Bgtw7.M Mother Bgtw7.M.m5 32.3 5 125 13,728 T34 Bgtw7 Bgtw7.M Mother Bgtw7.M.m6 32.5 6 167 25,899 TCP2 (runs 1 and 2) Bgtw7 Bgtw7.M Mother Bgtw7.M.m7 32.5 7 189 16,171 TCP2 (runs 1 and 2) Bgtw7 Bgtw7.M Mother Bgtw7.M.m8 32.6 8 214 21,054 TCP2 (runs 1 and 2) Bgtw7 Bgtw7.M Mother Bgtw7.M.m9 32.7 9 244 16,054 TCP2 (runs 1 and 2) Bgtw7 Bgtw7.M Mother Bgtw7.M.m10 32.8 10 275 16,972 T78 Bgtw7 Bgtw7.M Mother Bgtw7.M.m11 32.8 11 307 18,622 T78 Bgtw7 Bgtw7.M Mother Bgtw7.M.m12 32.9 12 336 17,114 T56 (runs 1 and 2) Bgtw7 Bgtw7.M Mother Bgtw7.M.m13 33.0 13 364 24,908 TCP2 (runs 1 and 2) Bgtw7 Bgtw7.M Mother Bgtw7.M.m14 33.1 14 397 25,642 T56 (runs 1 and 2) Bgtw7 Bgtw7.M Mother Bgtw7.M.m15 33.2 15 427 34,912 T56 (runs 1 and 2) Bgtw7 Bgtw7.M Mother Bgtw7.M.m16 33.2 16 455 26,763 T56 (runs 1 and 2) Bgtw8 Bgtw8.M Mother Bgtw8.M.m2 35.1 2 35 14,743 T34 Bgtw8 Bgtw8.M Mother Bgtw8.M.m3 35.2 3 64 12,586 T34 Bgtw8 Bgtw8.M Mother Bgtw8.M.m4 35.2 4 90 15,905 T12 Bgtw8 Bgtw8.M Mother Bgtw8.M.m5 35.3 5 122 22,094 T56 (runs 1 and 2) Bgtw8 Bgtw8.M Mother Bgtw8.M.m6 35.4 6 157 11,955 T12 Bgtw8 Bgtw8.M Mother Bgtw8.M.m7 35.5 7 185 12,986 T12 Bgtw8 Bgtw8.M Mother Bgtw8.M.m8 35.6 8 212 24,345 T56 (runs 1 and 2) Bgtw8 Bgtw8.M Mother Bgtw8.M.m9 35.7 9 247 24,921 T56 (runs 1 and 2) Bgtw8 Bgtw8.M Mother Bgtw8.M.m11 35.8 11 305 18,724 T56 (runs 1 and 2) Bgtw8 Bgtw8.M Mother Bgtw8.M.m12 35.9 12 333 22,064 T56 (runs 1 and 2) Bgtw8 Bgtw8.M Mother Bgtw8.M.m13 36.0 13 364 22,114 T78 Bgtw9 Bgtw9.M Mother Bgtw9.M.m2 20.1 2 38 21,305 TCP2 (runs 1 and 2) Bgtw9 Bgtw9.M Mother Bgtw9.M.m3 20.2 3 65 11,004 T12 Bgtw9 Bgtw9.M Mother Bgtw9.M.m4 20.3 4 93 17,898 T12 Bgtw9 Bgtw9.M Mother Bgtw9.M.m5 20.3 5 120 12,883 T12 Bgtw9 Bgtw9.M Mother Bgtw9.M.m7 20.5 7 185 22,936 TCP2 (runs 1 and 2) Bgtw9 Bgtw9.M Mother Bgtw9.M.m8 20.6 8 218 18,803 T78 Bgtw9 Bgtw9.M Mother Bgtw9.M.m10 20.7 10 273 16,732 TCP2 (runs 1 and 2) Bgtw9 Bgtw9.M Mother Bgtw9.M.m12 20.9 12 336 29,995 T56 (runs 1 and 2) Bgtw9 Bgtw9.M Mother Bgtw9.M.m13 21.0 13 368 19,398 T56 (runs 1 and 2) Bgtw10 Bgtw10.M Mother Bgtw10.M.m1 30.0 1 3 22,263 TCP2 (runs 1 and 2) Bgtw10 Bgtw10.M Mother Bgtw10.M.m2 30.1 2 33 18,615 T12 Bgtw10 Bgtw10.M Mother Bgtw10.M.m3 30.2 3 60 22,139 T12 Bgtw10 Bgtw10.M Mother Bgtw10.M.m4 30.3 4 93 19,762 TRX Bgtw10 Bgtw10.M Mother Bgtw10.M.m5 30.3 5 123 15,019 T78 Bgtw10 Bgtw10.M Mother Bgtw10.M.m6 30.4 6 154 24,658 T56 (runs 1 and 2) Bgtw10 Bgtw10.M Mother Bgtw10.M.m7 30.5 7 184 18,035 T78 Bgtw10 Bgtw10.M Mother Bgtw10.M.m8 30.6 8 212 19,391 T56 (runs 1 and 2) Bgtw10 Bgtw10.M Mother Bgtw10.M.m9 30.7 9 245 38,351 T56 (runs 1 and 2) Bgtw10 Bgtw10.M Mother Bgtw10.M.m10 30.7 10 271 26,347 T56 (runs 1 and 2) Bgtw10 Bgtw10.M Mother Bgtw10.M.m11 30.8 11 303 31,076 T56 (runs 1 and 2) Bgtw10 Bgtw10.M Mother Bgtw10.M.m12 30.9 12 332 27,492 T56 (runs 1 and 2) Bgtw10 Bgtw10.M Mother Bgtw10.M.m13 31.0 13 365 13,612 T78 Bgtw11 Bgtw11.M Mother Bgtw11.M.m1 21.0 1 3 26,161 T56 (runs 1 and 2) Bgtw11 Bgtw11.M Mother Bgtw11.M.m2 21.1 2 27 33,396 T56 (runs 1 and 2) Bgtw11 Bgtw11.M Mother Bgtw11.M.m3 21.2 3 60 38,371 T56 (runs 1 and 2) Bgtw11 Bgtw11.M Mother Bgtw11.M.m4 21.2 4 88 18,784 T78 Bgtw11 Bgtw11.M Mother Bgtw11.M.m5 21.3 5 120 31,702 T56 (runs 1 and 2) Bgtw11 Bgtw11.M Mother Bgtw11.M.m6 21.4 6 151 27,234 TCP2 (runs 1 and 2) Bgtw11 Bgtw11.M Mother Bgtw11.M.m7 21.5 7 192 18,199 TCP2 (runs 1 and 2) Bgtw11 Bgtw11.M Mother Bgtw11.M.m8 21.6 8 216 41,854 T56 (runs 1 and 2) Bgtw11 Bgtw11.M Mother Bgtw11.M.m9 21.7 9 243 19,865 T56 (runs 1 and 2) Bgtw11 Bgtw11.M Mother Bgtw11.M.m10 21.8 10 279 16,839 T78 Bgtw11 Bgtw11.M Mother Bgtw11.M.m11 21.8 11 306 20,396 T78 Bgtw11 Bgtw11.M Mother Bgtw11.M.m12 21.9 12 334 17,489 T78 Bgtw12 Bgtw12.M Mother Bgtw12.M.m1 22.0 1 7 18,105 T56 (runs 1 and 2) Bgtw12 Bgtw12.M Mother Bgtw12.M.m2 22.1 2 31 38,175 T56 (runs 1 and 2) Bgtw12 Bgtw12.M Mother Bgtw12.M.m3 22.2 3 60 16,379 T78 Bgtw12 Bgtw12.M Mother Bgtw12.M.m4 22.2 4 91 40,446 T56 (runs 1 and 2) Bgtw12 Bgtw12.M Mother Bgtw12.M.m5 22.3 5 125 12,674 T78 Bgtw12 Bgtw12.M Mother Bgtw12.M.m6 22.4 6 158 41,746 T56 (runs 1 and 2) Bgtw12 Bgtw12.M Mother Bgtw12.M.m7 22.5 7 187 21,437 T56 (runs 1 and 2) Bgtw12 Bgtw12.M Mother Bgtw12.M.m8 22.6 8 216 36,976 T56 (runs 1 and 2) Bgtw12 Bgtw12.M Mother Bgtw12.M.m9 22.7 9 245 15,573 T78 Bgtw12 Bgtw12.M Mother Bgtw12.M.m10 22.8 10 280 16,713 T78 Bgtw12 Bgtw12.M Mother Bgtw12.M.m11 22.9 11 314 16,498 T78 Bgtw12 Bgtw12.M Mother Bgtw12.M.m12 22.9 12 341 15,881 TRX Bgtw12 Bgtw12.M Mother Bgtw12.M.m13 23.0 13 372 17,612 TRX

TABLE 3 Characteristics of children in training and validation sets used for Random Forests age-discriminatory model (a) Training Set Characteristics Training Weight-for-Height Z score −0.32 ± 1     Male/Female 7/5 Number of fecal samples collected per child 22.7 ± 1.5  Age at first fecal sample collection (days) 6 ± 1 Age at last fecal sample collection (days) 712 ± 15  Mean sampling interval (days)  33 ± 3.0 Months of exclusive breastfeeding 3.2 ± 2.3 Age of first introduction of solid food (months) 6.3 ± 2.3 Number of diarrhoeal episodes per year 4.0 ± 1.9 % Days with diarrhoea during sampling period 3.9 ± 1.7 Fraction of samples collected where antibiotics 0.2 ± 0.1 had been consumed within prior 7 days (b) Validation Characteristics Validation Weight-for-Height Z score −0.44 ± 0.8  Male/Female 9/4 Number of fecal samples collected per child 21.2 ± 2.2  Age at first fecal sample collection (days) 7 ± 4 Age at last fecal sample collection (days) 709 ± 9  Mean sampling interval (days) 35.1 ± 4.3  Months of exclusive breastfeeding 3.6 ± 2.3 Age of first introduction of solid food (months) 6.4 ± 6.4 Number of diarrhoeal episodes per year 4.6 ± 2.4 % Days with diarrhoea during sampling period 4.3 ± 2.7 Fraction of samples collected where antibiotics 0.2 ± 0.2 had been consumed within prior 7 days (c) Validation - Twins & Triplets Validation - Characteristics Twins & Triplets Weight-for-Height Z score −0.46 ± 0.7  Male/Female 7/18 Number of fecal samples collected per child 17.9 ± 5.3  Age at first fecal sample collection (days) 13 ± 12 Age at last fecal sample collection (days) 497 ± 147 Mean sampling interval (days)  29 ± 3.1 Months of exclusive breastfeeding 0.7 ± 2.3 Age of first introduction of solid food (months) 7.0 ± 1.9 Number of diarrhoeal episodes per year 1.7 ± 1.3 % Days with diarrhoea during sampling period 2.2 ± 2.6 Fraction of samples collected where antibiotics 0.1 ± 0.1 had been consumed within prior 7 days Mean values ± SD are shown

TABLE 4 Bacterial V4-16S rRNA sequencing statistics V4-16S rRNA reads Number Total number per sample of fecal of high Study Subjects (mean ± SD) samples quality reads 50 Healthy Children  25,288 ± 13,990 996 25,187,256 (Singletons, Twins and Triplets) Mothers & Fathers 20,233 ± 7,120 243 4,916,630 Severe Acute  21,545 ± 15,731 589 12,689,785 Malnutrition Randomized Clinical Trial Moderate Acute 22,964 ± 8,713 22 505,207 Malnutrition Cross- Sectional Analysis Concordant Healthy 151,578 ± 65,521 47 7,124,158 Malawian Twins and Triplets 1897 50,423,036

TABLE 5 16S rRNA sequences and annotation of age-discriminatory bacterial taxa in order of feature importance Age 16S rRNA discriminatory Rank OTU ID feature RDP 2.4 Taxonomic Order / (as importance Annotation SEQ ID shown in score (mean ± (Phylum; Class; Order;  NO FIG. 1) SD) Family; Genus; Species) Representative 16S rRNA Sequence of the 97% ID OTU cluster 1 326792 9.64 Firmicutes; Clostridia; Clostridiales; AACGTAGGTCACAAGCGTTGTCCGGAATTACTGGGTGTAAAGGG ± Ruminococcaceae; Faecalibacterium; AGCGCAGGCGGGAGAACAAGTTGGAAGTGAAATCCATGGGCTC 0.29 Faecalibacterium_prausnitzii AACCCATGAACTGCTTTCAAAACTGTTTTTCTTGAGTAGTGCAGA GGTAGGCGGAATTCCCGGTGTAGCGGTGGAATGCGTAGATATC GGGAGGAACACCAGTGGCGAAGGCGGCCTACTGGGCACCAAC TGACGCTGAGGCTCGAAAGTGTGGGTAGCAAACAGG 2 189827 7.21 Firmicutes; Clostridia; Clostridiales; TACGTAGGGGGCAAGCGTTATCCGGATTTACTGGGTGTAAAGG Ruminococcaceae; Ruminococcus; GAGCGTAGACGGTGTGGCAAGTCTGATGTGAAAGGCATGGGCT ± Ruminococcus_sp_5_1_39BFAA CAACCTGTGGACTGCATTGGAAACTGTCATACTTGAGTGCCGGA 0.38 GGGGTAAGCGGAATTCCTAGTGTAGCGGTGAAATGCGTAGATAT TAGGAGGAACACCAGTGGCGAAGGCGGCTTACTGGACGGTAAC TGACGTTGAGGCTCGAAAGCGTGGGGAGCAAACAGG 3 470663 3.89 Firmicutes; Bacilli; Lactobacillales; TACGTAGGTGGCGAGCGTTGTCCGGATTTATTGGGCGTAAAGG ± Lactobacillaceae; Lactobacillus; GAACGCAGGCGGTCTTTTAAGTCTGATGTGAAAGCCTTCGGCTT 0.22 Lactobacillus_ruminis AACCGAAGTAGTGCATTGGAAACTGGAAGACTTGAGTGCAGAAG AGGAGAGTGGAACTCCATGTGTAGCGGTGAAATGCGTAGATATA TGGAAGAACACCAGTGGCGAAAGCGGCTCTCTGGTCTGTAACT GACGCTGAGGTTCGAAAGCGTGGGTAGCAAACAGG 4 191687 3.27 Firmicutes; Clostridia; Clostridiales; TACGTAGGGGGCAAGCGTTATCCGGATTTACTGGGTGTAAAGG ± Lachnospiraceae; Dorea; GAGCGTAGACGGCACGGCAAGCCAGATGTGAAAGCCCGGGGC 0.23 Dorea_longicatena TCAACCCCGGGACTGCATTTGGAACTGCTGAGCTAGAGTGTCG GAGAGGCAAGTGGAATTCCTAGTGTAGCGGTGAAATGCGTAGAT ATTAGGAGGAACACCAGTGGCGAAGGCGGCTTGCTGGACGATG ACTGACGTTGAGGCTCGAAAGCGTGGGGAGCAAACAGG 5 72820 2.86 Actinobacteria; 1760; Bifidobacteriales; TACGTAGGGTGCAAGCGTTATCCGGAATTATTGGGCGTAAAGGG ± Bifidobacteriaceae; Bifidobacterium; CTCGTAGGCGGTTCGTCGCGTCCGGTGTGAAAGTCCATCGCTT 0.14 Bifidobacterium_longum AACGGTGGATCCGCGCCGGGTACGGGCGGGCTTGAGTGCGGT AGGGGAGACTGGAATTCCCGGTGTAACGGTGGAATGTGTAGAT ATCGGGAAGAACACCAATGGCGAAGGCAGGTCTCTGGGCCGTT ACTGACGCTGAGGAGCGAAAGCGTGGGGAGCGAACAGG 6 194745 2.43 Firmicutes; Clostridia; Clostridiales; TACGTAGGGGGCAAGCGTTATCCGGATTTACTGGGTGTAAAGG ± Ruminococcaceae; Ruminococcus; GAGCGTAGACGGTGTGGCAAGTCTGATGTGAAAGGCATGGGCT 0.19 Ruminococcus_sp_5_1_39BFAA CAACCCGTGGACTGCATTGGAAACTGTCATACTTGAGTGCCGGA GGGGTAAGCGGAATTCCTAGTGTAGCGGTGAAATGCGTAGATAT TAGGAGGAACACCAGTGGCGAAGGCGGCTTACTGGACGGTAAC TGACGTTGAGGCTCGAAAGCGTGGGGAGCAAACAGG 7 15141 1.98 Firmicutes; Bacilli; Lactobacillales; TACGTAGGTGGCAAGCGTTATCCGGATTTATTGGGCGTAAAGCG ± Lactobacillaceae; Lactobacillus; AGCGCAGGCGGTTTGATAAGTCTGATGTGAAAGCCTTTGGCTTA 0.12 Lactobacillus_ mucosae ACCAAAGAAGTGCATCGGAAACTGTCAGACTTGAGTGCAGAAGA GGACAGTGGAACTCCATGTGTAGCGGTGGAATGCGTAGATATAT GGAAGAACACCAGTGGCGAAGGCGGCTGTCTGGTCTGCAACTG ACGCTGAGGCTCGAAAGCATGGGTAGCGAACAGG 8 561483 1.59 Actinobacteria; 1760; Bifidobacteriales; TACGTAGGGTGCAAGCGTTATCCGGAATTATTGGGCGTAAAGGG ± Bifidobacteriaceae; CTCGTAGGCGGTTCGTCGCGTCCGGTGTGAAAGTCCATCGCTT 0.10 Bifidobacterium AACGGTGGATCCGCGCCGGGTACGGGCGGGCTTGAGTGCGGT AGGGGAGACTGGAATTCCCGGTGTAACGGTGGAATGTGTAGAT ATCGGGAAGAACACCAATGGCGAAGGCAGGTCTCTGGGCCGTT ACTGACGCTGAGGAGCGGAAGCGTGGGGAGCGAACAGG 9 217996 0.99 Firmicutes; Bacilli; Bacillales TACGTAGGTGGCAAGCGTTATCCGGAATTATTGGGCGTAAAGCG ± Staphylococcaceae; Staphylococcus CGCGTAGGCGGTTTTTTAAGTCTGATGTGAAAGCCCACGGCTCA 0.06 ACCGTGGAGGGTCATTGGAAACTGGAAAACTTGAGTGCAGAAG AGGAAAGTGGAATTCCATGTGTAGCGGTGAGATGCGCAGAGAT ATGGAGGAACACCAGTGGCGAAGGCGACTTTCTGGTCTGTAACT GACGCTGATGTGCGAAAGCGTGGGGATCAAACAGG 10 364234 0.95 Firmicutes; Clostridia; Clostridiales; TACGTAGGGTGCAAGCGTTATCCGGATTTACTGGGTGTAAAGGG ± Ruminococcaceae; Ruminococcus; AGCGTAGACGGTGTGGCAAGTCTGATGTGAAAGGCATGGGCTC 0.12 Ruminococcus_sp_5_1_39BFAA AACCTGTGGACTGCATTGGAAACTGTCATACTTGAGTGCCGGAG GGGTAAGCGGAATTCCTAGTGTAGCGGTGAAATGCGTAGATATT AGGAGGAACACCAGTGGCGAAGGCGGCTTACTGGACGGTAACT GACGTTGAGGCTCGAAAGCGTGGGGAGCAAACAGG 11 287510 0.92 Firmicutes; Erysipelotrichi; TACGTAGGTGGCGAGCGTTATCCGGAATCATTGGGCGTAAAGA ± Erysipelotrichales; GGGAGCAGGCGGCCGCAAGGGTCTGTGGTGAAAGACCGAAGC 0.08 Erysipelotrichaceae; Catenibacterium;  TAAACTTCGGTAAGCCATGGAAACCGGGCGGCTAGAGTGCGGA Catenibacterium_mitsuokai AGAGGATCGTGGAATTCCATGTGTAGCGGTGAAATGCGTAGATA TATGGAGGAACACCAGTGGCGAAGGCGACGGTCTGGGCCGCAA CTGACGCTCATTCCCGAAAGCGTGGGGAGCAAATAGG 12 261912 0.88 Firmicutes; Clostridia; Clostridiales; TACGTAGGGGGCAAGCGTTATCCGGATTTACTGGGTGTAAAGG ± Lachnospia; Dorea; GAGCGTAGACGGCTGTGCAAGTCTGAAGTGAAAGGCATGGGCT 0.10 Dorea_formicigeneans CAACCTGTGGACTGCTTTGGAAACTGTGCAGCTAGAGTGTCGGA GAGGTAAGTGGAATTCCTAGTGTAGCGGTGAAATGCGTAGATAT TAGGAGGAACACCAGTGGCGAAGGCGGCTTACTGGACGATGAC TGACGTTGAGGCTCGAAAGCGTGGGGAGCAAACAGG 13 361809 0.61 Firmicutes; Clostridia; Clostridiales; TACGTATGGTGCAAGCGTTATCCGGATTTACTGGGTGTAAAGGG ± Ruminococcaceae; Ruminococcus; AGCGTAGACGGAGTGGCAAGTCTGATGTGAAAACCCGGGGCTC 0.11 Ruminococcus_torques AACCCCGGGACTGCATTGGAAACTGTCAATCTAGAGTACCGGAG AGGTAAGCGGAATTCCTAGTGTAGCGGTGAAATGCGTAGATATT AGGAGGAACACCAGTGGCGAAGGCGGCTTACTGGACGGTAACT GACGTTGAGGCTCGAAAGCGTGGGGAGCAAACAGG 14 108747 0.52 Firmicutes; Bacilli; Lactobacillales; TACGTAGGTCCCGAGCGTTGTCCGGATTTATTGGGCGTAAAGCG ± Streptococcaceae; Streptococcus; AGCGCAGGCGGTTTGATAAGTCTGAAGTTAAAGGCTGTGGCTCA 0.05 Streptococcus_thermophilus ACCATAGTTCGCTTTGGAAACTGTCAAACTTGAGTGCAGAAGGG GAGAGTGGAATTCCATGTGTAGCGGTGAAATGCGTAGATATATG GAGGAACACCGGTGGCGAAAGCGGCTCTCTGGTCTGTAACTGA CGCTGAGGCTCGAAAGCGTGGGGAGCGAACAGG 15 533785 0.51 Actinobacteria; 1760; TACGTAGGGCGCAAGCGTTATCCGGATTTATTGGGCGTAAAGG ± Bifidobacteriales; Bifidobacteriaceae;  GCTCGTAGGCGGTTCGTCGCGTCCGGTGTGAAAGTCCATCGCT 0.05 Bifidobacterium TAACGGTGGATCCGCGCCGGGTACGGGCGGGCTTGAGTGCGG TAGGGGAGACTGGAATTCCCGGTGTAACGGTGGAATGTGTAGA TATCGGGAAGAACACCAATGGCGAAGGCAGGTCTCTGGGCCGT TACTGACGCTGAGGAGCGAAAGCGTGGGGAGCGAACAGG 16 9514 0.46 Proteobacteria; Gammaproteobacteria; TACGGAGGGTGCGAGCGTTAATCGGAATAACTGGGCGTAAAGG ± Pasteurellales; Pasteurellaceae; GCACGCAGGCGGTGACTTAAGTGAGGTGTGAAAGCCCCGGGCT 0.06 Haemophilus; Haemophilus_ TAACCTGGGAATTGCATTTCATACTGGGTCGCTAGAGTACTTTAG parainfluenzae GGAGGGGTAGAATTCCACGTGTAGCGGTGAAATGCGTAGAGAT GTGGAGGAATACCGAAGGCGAAGGCAGCCCCTTGGGAATGTAC TGACGCTCATGTGCGAAAGCGTGGGGAGCAAACAGG 17 561636 0.42 Firmicutes; Bacilli; Lactobacillales; TACGTAGGTCCCGAGCGTTATCCGGATTTATTGGGCGTAAAGCG ± Streptococcaceae; Streptococcus AGCGCAGGCGGTTAGATAAGTCTGAAGTTAAAGGCTGTGGCTTA 0.05 ACCATAGTACGCTTTGGAAACTGTTTAACTTGAGTGCAAGAGGG GAGAGTGGAATTCCATGTGTAGCGGTGAAATGCGTAGATATATG GAGGAACACCGGTGGCGAAAGCGGCTCTCTGGCTTGTAACTGA CGCTGAGGCTCGAAAGCGTGGGGAGCAAACAGG 18 312461 0.42 Firmicutes; Clostridia; Clostridiales; TACGTAGGGGGCTAGCGTTATCCGGAATTACTGGGCGTAAAGG ± Clostridiaceae; Clostridium GTGCGTAGGTGGTTTCTTAAGTCAGAGGTGAAAGGCTACGGCTC 0.04 AACCGTAGTAAGCCTTTGAAACTGGGAAACTTGAGTGCAGGAGA GGAGAGTGGAATTCCTAGTGTAGCGGTGAAATGCGTAGATATTA GGAGGAACACCAGTTGCGAAGGCGGCTCTCTGGACTGTAACTG ACACTGAGGCACGAAAGCGTGGGGAGCAAACAGG 19 470139 0.40 Firmicutes; Erysipelotrichi; TACGTAGGTGGCAAGCGTTATCCGGAATTATTGGGCGTAAAGAG ± Erysipelotrichales; GGAGCAGGCGGCAGCAAGGGTCTGTGGTGAAAGCCTGAAGCTT 0.05 Erysipelotrichaceae; unclassified_ AACTTCAGTAAGCCATAGAAACCAGGCAGCTAGAGTGCAGGAGA Erysipelotrichaceae; Clostridium_ GGATCGTGGAATTCCATGTGTAGCGGTGAAATGCGTAGATATAT ramosum GGAGGAACACCAGTGGCGAAGGCGACGATCTGGCCTGCAACTG ACGCTCAGTCCCGAAAGCGTGGGGAGCAAATAGG 20 181834 0.38 Firmicutes; Clostridia; Clostridiales; TACGTAGGGGGCAAGCGTTATCCGGATTTACTGGGTGTAAAGG ± Clostridiaceae; Clostridium GAGCGCAGACGGCGATGCAAGTCTGAAGTGAAAGCCCGGGGCT 0.08 CAACCCCGGGACTGCTTTGGAAACTGTATGGCTAGAGTGCTGG AGAGGCAAGCGGAATTCCTAGTGTAGCGGTGAAATGCGTAGATA TTAGGAAGAACACCAGTGGCGAAGGCGGCTTGCTGGACAGTAA CTGACGTTCAGGCTCGAAAGCGTGGGGAGCAAACAGG 21 148099 0.38 Firmicutes; Bacilli; Lactobacillales; TACGTATGTTCCAAGCGTTATCCGGATTTATTGGGCGTAAAGCG ± Leuconostocaceae; Weissella; AGCGCAGACGGTTATTTAAGTCTGAAGTGAAAGCCCTCAGCTCA 0.05 Weissella_cibaria ACTGAGGAATTGCTTTGGAAACTGGATGACTTGAGTGCAGTAGA GGAAAGTGGAACTCCATGTGTAGCGGTGAAATGCGTAGATATAT GGAAGAACACCAGTGGCGAAGGCGGCTTTCTGGACTGTAACTG ACGTTGAGGCTCGAAAGTGTGGGTAGCAAACAGG 22 469873 0.36 Actinobacteria; 1760; Bifidobacteriales; TACGTAGGGTGCAAGCGTTATCCGGAATTATTGGGCGTAAAGGG ± Bifidobacteriaceae; CTCGTAGGCGGTTCGTCGCGTCCGGTGTGAAAGTCCATCGCTT 0.05 Bifidobacterium AACGGTGGATCTGCGCCGGGTACGGGCGGGCTGGAGTGCGGT AGGGGAGACTGGAATTCCCGGTGTAACGGTGGAATGTGTAGAT ATCGGGAAGAACACCAATGGCGAAGGCAGGTCTCTGGGCCGTT ACTGACGCTGAGGAGCGAAAGCGTGGGGAGCGAACAGG 23 185951 0.35 Firmicutes; Clostridia; Clostridiales TACGTAGGGGGCAAGCGTTATCCGGATTTACTGGGTGTAAAGG ± GAGCGTAGACGGATGGACAAGTCTGATGTGAAAGGCTGGGGCT 0.06 CAACCCCGGGACTGCATTGGAAACTGCCCGTCTTGAGTGCCGG AGAGGTAAGCGGAATTCCTAGTGTAGCGGTGAAATGCGTAGATA TTAGGAGGAACACCAGTGGCGAAGGCGGCTTACTGGACGGTAA CTGACGTTGAGGCTCGAAAGCGTGGGGAGCAAACAGG 24 212619 0.31 Firmicutes; Clostridia; Clostridiales; AACGTAGGGTGCAAGCGTTGTCCGGAATTACTGGGTGTAAAGG ± Ruminococcaceae GAGCGCAGGCGGACCGGCAAGTTGGAAGTGAAAACTATGGGCT 0.04 CAACCCATAAATTGCTTTCAAAACTGCTGGCCTTGAGTAGTGCA GAGGTAGGTGGAATTCCCGGTGTAGCGGTGGAATGCGTAGATA TCGGGAGGAACACCAGTGGCGAAGGCGACCTACTGGGCACCAA CTGACGCTGAGGCTCGAAAGCATGGGTAGCAAACAGG 25 469852 0.29 Actinobacteria; 1760; Bifidobacteriales; TACGTAGGGCGCAAGCGTTATCCGGATTTATTGGGCGTAAAGG ± Bifidobacteriaceae; GCTCGTAGGCGGCTCGTCGCGTCCGGTGTGAAAGTCCATCGCT 0.05 Bifidobacterium; Bifidobacterium_ TAACGGTGGATCTGCGCCGGGTACGGGCGGGCTGGAGTGCGG bifidum TAGGGGAGACTGGAATTCCCGGTGTAACGGTGGAATGTGTAGA TATCGGGAAGAACACCGATGGCGAAGGCAGGTCTCTGGGCCGT CACTGACGCTGAGGAGCGAAAGCGTGGGGAGCGAACAGG 26 170124 0.28 Firmicutes; Clostridia; Clostridiales; TACGTAGGGAGCAAGCGTTATCCGGATTTACTGGGTGTAAAGGG ± Eubacteriaceae; Eubacterium; CGCGCAGGCGGGCCGGCAAGTTGGAAGTGAAATCTATGGGCTT 0.06 Eubacterium_desmolans AACCCATAAACTGCTTTCAAAACTGCTGGTCTTGAGTGATGGAG AGGCAGGCGGAATTCCGTGTGTAGCGGTGAAATGCGTAGATAT ACGGAGGAACACCAGTGGCGAAGGCGGCCTGCTGGACATTAAC TGACGCTGAGGCGCGAAAGCGTGGGGAGCAAACAGG 27 187010 0.28 Firmicutes; Clostridia; Clostridiales; TACGTAGGTCACAAGCGTTGTCCGGAATTACTGGGTGTAAAGGG ± Ruminococcaceae; Faecalibacterium; AGCGCAGGCGGGAGAGCAAGTTGGAAGTGAAATCCATGGGCTC 0.06 Faecalibacterium_prausnitzii AACCCATGAACTGCTTTCAAAACTGTTTTTCTTGAGTAGTGCAGA GGTAGGCGGAATTCCCGGTGTAGCGGTGGAATGCGTAGATATC GGGAGGAACACCAGTGGCGAAGGCGGCCTACTGGGCACCAAC TGACGCTGAGGCTCGAAAGTGTGGGTAGCAAACAGG 28 303304 0.27 Bacteroidetes; Bacteroidia; TACGGAAGGTCCGGGCGTTATCCGGATTTATTGGGTTTAAAGGG ± Bacteroidales; Prevotellaceae; AGCGTAGGCCGGAGATTAAGCGTGTTGTGAAATGTAGACGCTCA 0.05 Prevotella; Prevotella_copri ACGTCTGCACTGCAGCGCGAACTGGTTTCCTTGAGTACGCACAA AGTGGGCGGAATTCGTGGTGTAGCGGTGAAATGCTTAGATATCA CGAAGAACTCCGATTGCGAAGGCAGCTCACTGGAGCGCAACTG ACGCTGAAGCTCGAAAGTGCGGGTATCGAACAGG 29 470527 0.26 Firmicutes; Bacilli; Lactobacillales; TACGTAGGTGGCAAGCGTTATCCGGATTTATTGGGCGTAAAGCG ± Lactobacillaceae; Lactobacillus; AGCGCAGGCGGTTGCTTAGGTCTGATGTGAAAGCCTTCGGCTTA 0.03 Lactobacillus_reuteri ACCGAAGAAGTGCATCGGAAACCGGGCGACTTGAGTGCAGAAG AGGACAGTGGAACTCCATGTGTAGCGGTGGAATGCGTAGATATA TGGAAGAACACCAGTGGCGAAGGCGGCTGTCTGGTCTGCAACT GACGCTGAGGCTCGAAAGCATGGGTAGCGAACAGG 30 210269 0.25 Proteobacteria; Gammaproteobacteria; TACGGAGGGTGCAAGCGTTAATCGGAATTACTGGGCGTAAAGC ± Enterobacteriales; GCACGCAGGCGGTCTGTCAAGTCGGATGTGAAATCCCCGGGCT 0.04 Enterobacteriaceae CAACCTGGGAACTGCATTCGAAACTGGCAGGCTAGAGTCTTGTA GAGGGGGGTAGAATTCCAGGTGTAGCGGTGAAATGCGTAGAGA TCTGGAGGAATACCGGTGGCGAAGGCGGCCCCCTGGACAAAGA CTGACGCTCAGGTGCGAAAGCGTGGGGAGCAAACAGG 31 182202 0.24 Firmicutes; Clostridia; Clostridiales; TACGTAGGGGGCTAGCGTTATCCGGATTTACTGGGCGTAAAGG ± Clostridiaceae; Clostridium; GTGCGTAGGTGGTTTCTTAAGTCAGGAGTGAAAGGCTACGGCTC 0.03 Clostridium_glycolicum AACCGTAGTAAGCTCTTGAAACTGGGAAACTTGAGTGCAGGAGA GGAAAGTGGAATTCCTAGTGTAGCGGTGAAATGCGTAGATATTA GGAGGAACACCAGTAGCGAAGGCGGCTTTCTGGACTGTAACTG ACACTGAGGCACGAAAGCGTGGGGAGCAAACAGG 32 178122 0.23 Firmicutes; Clostridia; Clostridiales; TACGTAGGGGGCAAGCGTTATCCGGATTTACTGGGTGTAAAGG ± Ruminococcaceae; Ruminococcus; GAGCGTAGACGGACTGGCAAGTCTGATGTGAAAGGCGGGGGCT 0.06 Ruminococcus_obeum CAACCCCTGGACTGCATTGGAAACTGTTAGTCTTGAGTGCCGGA GAGGTAAGCGGAATTCCTAGTGTAGCGGTGAAATGCGTAGATAT TAGGAGGAACACCAGTGGCGAAGGCGGCTTACTGGACGGTAAC TGACGTTGAGGCTCGAAAGCGTGGGGAGCAAACAGG 33 540230 0.21 Firmicutes; Bacilli; Lactobacillales; TACGTAGGTGGCAAGCGTTGTCCGGATTTATTGGGCGTAAAGCG ± Enterococcaceae; Enterococcus; AGCGCAGGCGGTTTCTTAAGTCTGATGTGAAAGCCCCCGGCTC 0.04 Enterococcus_faecalis AACCGGGGAGGGTCATTGGAAACTGGGAGACTTGAGTGCAGAA GAGGAGAGTGGAATTCCATGTGTAGCGGTGAAATGCGTAGATAT ATGGAGGAACACCAGTGGCGAAGGCGGCTCTCTGGTCTGTAAC TGACGCTGAGGCTCGAAAGCGTGGGGAGCAAACAGG 34 309068 0.18 Bacteroidetes; Bacteroidia; TACGGAAGGTCCGGGCGTTATCCGGATTTATTGGGTTTAAAGGG ± Bacteroidales; Prevotellaceae; AGCGTAGGCCGGAGATTAAGCGTGTTGTGAAATGTAGATGCTCA 0.04 Prevotella; Prevotella_copri ACATCTGCACTGCAGCGCGAACTGGTTTCCTTGAGTACGCACAA AGTGGGCGGAATTCGTGGTGTAGCGGTGAAATGCTTAGATATCA CGAAGAACTCCGATTGCGAAGGCAGCTCACTGGAGCGCAACTG ACGCTGAAGCTCGAAAGTGCGGGTATCGAACAGG 35 24773 0.16 Actinobacteria; 1760; Bifidobacteriales; TACGTAGGGTGCAAGCGTTATCCGGAATTATTGGGCGTAAAGGG ± Bifidobacteriaceae; CTCGTAGGCGGTTCGTCGCGTCCGGTGTGAAAGTCCATCGCTT 0.03 Bifidobacterium AACGGTGGATCTGCGCCGGGTACGGGCGGGCTGGAGTGCGGT AGGGGAGACTGGAATTCCCGGTGTAACGGTGGAATGTGTAGAT ATCGGGAAGAACACCGATGGCGAAGGCAGGTCTCTGGGCCGTC ACTGACGCTGAGGAGCGAAAGCGTGGGGAGCGAACAGG 36 554755 0.16 Firmicutes; Bacilli; Lactobacillales; TACGTAGGTGGCAAGCGTTATCCGGATTTATTGGGCGTAAAGCG ± Enterococcaceae; Enterococcus AGCGCAGGCGGTTTCTTAAGTCTGATGTGAAAGCCCCCGGCTC 0.03 AACCGGGGAGGGTCATTGGAAACTGGGAAACTTGAGTGCAGAA GAGGAGAGTGGAATTCCATGTGTAGCGGTGAAATGCGTAGATAT ATGGAGGAACACCAGTGGCGAAAGCGGCTCTCTGGTCTGTAAC TGACGCTGAGGTTCGAAAGCGTGGGTAGCAAACAGG 37 305760 0.15 Proteobacteria; Gammaproteobacteria; TACGGAGGGTGCAAGCGTTAATCGGAATTACTGGGCGTAAAGC ± Enterobacteriales; GCACGCAGGCGGTTTGTTAAGTCAGATGTGAAATCCCCGGGCT 0.04 Enterobacteriaceae; Escherichia; CAACCTGGGAACTGCATCTGATACTGGCAAGCTTGAGTCTCGTA Escherichia_coli GAGGGGGGTAGAATTCCAGGTGTAGCGGTGAAATGCGTAGAGA TCTGGAGGAATACCGGTGGCGAAGGCGGCCCCCTGGACGAAG ACTGACGCTCAGGTGCGAAAGCGTGGGGAGCAAACAGG 38 268604 0.15 Bacteroidetes; Bacteroidia;  TACGGAAGGTCCGGGCGTTATCCGGATTTATTGGGTTTAAAGGG ± Bacteroidales; Prevotellaceae; AGCGCAGGCGGACCTTTAAGTCAGCTGTGAAATACGGCGGCTC 0.03 Prevotella AACCGTCGAACTGCAGTTGATACTGGAGGTCTTGAGTGCACACA GGGATGCTGGAATTCATGGTGTAGCGGTGAAATGCTCAGATATC ATGAAGAACTCCGATCGCGAAGGCAGGCATCCGGGGTGCAACT GACGCTGAGGCTCGAAAGTGCGGGTATCAAACAGG 39 188900 0.15 Firmicutes; Clostridia; Clostridiales; AACGTAGGTCACAAGCGTTGTCCGGAATTACTGGGTGTAAAGGG ± Ruminococcaceae; Faecalibacterium; AGCGCAGGCGGGAGAACAAGTTGGAAGTGGAATCCATGGGCTC 0.04 Faecalibacterium_prausnitzii AACCCATGAACTGCTTTCAAAACTGTTTTTCTTGAGTAGTGCAGA GGTAGGCGGAATTCCCGGTGTAGCGGTGGAATGCGTAGATATC GGGAGGAACACCAGTGGCGAAGGCGGCCTACTGGGCACCAAC TGACGCTGAGGCTCGAAAGTGTGGGTAGCAAACAGG 40 174256 0.14 Firmicutes; Clostridia; Clostridiales; TACGTATGGAGCAAGCGTTATCCGGATTTACTGGGTGTAAAGGG ± Eubacteriaceae; Eubacterium; TGCGTAGGTGGCAGTGCAAGTCAGATGTGAAAGGCCGGGGCTC 0.03 Eubacterium_hallii AACCCCGGAGCTGCATTTGAAACTGCTCGGCTAGAGTACAGGA GAGGCAGGCGGAATTCCTAGTGTAGCGGTGAAATGCGTAGATA TTAGGAGGAACACCAGTGGCGAAGGCGGCCTGCTGGACTGTTA CTGACACTGAGGCACGAAAGCGTGGGGAGCAAACAGG 41 130663 0.14 Bacteroidetes; Bacteroidia; TACGGAGGATCCGAGCGTTATCCGGATTTATTGGGTTTAAAGGG ± Bacteroidales; Bacteroidaceae; AGCGTAGGTGGACTGGTAAGTCAGTTGTGAAAGTTTGCGGCTCA 0.03 Bacteroides; Bacteroides_fragilis ACCGTAAAATTGCAGTTGATACTGTCAGTCTTGAGTACAGTAGA GGTGGGCGGAATTCGTGGTGTAGCGGTGAAATGCTTAGATATCA CGAAGAACTCCGATTGCGAAGGCAGCTCACTGGACTGCAACTG ACACTGATGCTCGAAAGTGTGGGTATCAAACAGG 42 292424 0.14 Firmicutes; Bacilli; Lactobacillales; TACGTAGGTCCCGAGCGTTGTCCGGATTTATTGGGCGTAAAGCG ± Streptococcaceae; Streptococcus AGCGCAGGCGGTTTAATAAGTCTGAAGTTAAAGGCAGTGGCTTA 0.04 ACCATTGTTCGCTTTGGAAACTGTTAGACTTGAGTGCAGAAGGG GAGAGTGGAATTCCATGTGTAGCGGTGAAATGCGTAGATATATG GAGGAACACCGGTGGCGAAAGCGGCTCTCTGGTCTGTAACTGA CGCTGAGGCTCGAAAGCGTGGGGAGCAAACAGG 43 269541 0.14 Firmicutes; Bacilli; Bacillales TACGTAGGTGGCAAGCGTTATCCGGAATTATTGGGCGTAAAGCG ± Staphylococcaceae; Staphylococcus CGCGTAGGCGGTTTTTTAAGTCTGATGTGAAAGCCCACGGCTCA 0.03 ACCGTGGAGGGTCATTGGAAACTGGAAAACTTGAGTGCAGAAG AGGAAAGTGGAATTCCATGTGTAGCGGTGAAATGCGCAGAGATA TGGAGGAACACCAGTGGCGAAGGCGACTTTCTGGTCTGTAACT GACGCTGATATGCGAAAGCGTGGGGATCAAACAGG 44 191900 0.13 Firmicutes; Clostridia; Clostridiales; TACGTAGGGGGCAAGCGTTATCCGGATTTACTGGGTGTAAAGG ± Ruminococcaceae; Ruminococcus; GAGCGTAGACGGTGCGGCAAGTCTGATGTGAAAGGCATGGGCT 0.03 Ruminococcus_sp_5_1_39BFAA CAACCTGTGGACTGCATTGGAAACTGTCATACTTGAGTGCCGGA GGGGTAAGCGGAATTCCTAGTGTAGCGGTGAAATGCGTAGATAT TAGGAGGAACACCAGTGGCGAAGGCGGCTTACTGGACGGCAAC TGACGTTGAGGCTCGAAAGCGTGGGGAGCAAACAGG 45 48207 0.13 Firmicutes; Negativicutes; TACGTAGGTGGCAAGCGTTGTCCGGAATTATTGGGCGTAAAGC ± Selenomonadales; Veillonellaceae; GCGCGCAGGCGGCTTCTTAAGTCCATCTTAAAAGTGCGGGGCT 0.03 Dialister TAACCCCGTGATGGGATGGAAACTGAGAGGCTGGAGTATCGGA GAGGAAAGTGGAATTCCTAGTGTAGCGGTGAAATGCGTAGAGAT TAGGAAGAACACCGGTGGCGAAGGCGACTTTCTGGACGACAAC TGACGCTGAGGCGCGAAAGCGTGGGGAGCAAACAGG 46 186029 0.12 Actinobacteria; 1760; Coriobacteriales; TACGTAGGGGGCGAGCGTTATCCGGATTCATTGGGCGTAAAGC ± Coriobacteriaceae; GCGCGTAGGCGGCCCGGCAGGCCGGGGGTCGAAGCGGGGGG 0.03 Collinsella; Collinsella_aerofaciens CTCAACCCCCCGAAGCCCCCGGAACCTCCGCGGCTTGGGTCCG GTAGGGGAGGGTGGAACACCCGGTGTAGCGGTGGAATGCGCA GATATCGGGTGGAACACCGGTGGCGAAGGCGGCCCTCTGGGC CGAGACCGACGCTGAGGCGCGAAAGCTGGGGGAGCGAACAGG 47 325608 0.11 Firmicutes; Clostridia; Clostridiales; TACGTAGGGGGCTAGCGTTATCCGGATTTACTGGGCGTAAAGG ± Clostridiaceae; Clostridium; GTGCGTAGGCGGTCTTTTAAGTCAGGAGTGAAAGGCTACGGCT 0.04 Clostridium_bartlettii CAACCGTAGTAAGCTCTTGAAACTGGAGGACTTGAGTGCAGGAG AGGAGAGTGGAATTCCTAGTGTAGCGGTGAAATGCGTAGATATT AGGAGGAACACCAGTAGCGAAGGCGGCTCTCTGGACTGTAACT GACGCTGAGGCACGAAAGCGTGGGGAGCAAACAGG 48 252321 0.11 Firmicutes; Bacilli; Lactobacillales; TACGTAGGGTGCAAGCGTTGTCCGGATTTATTGGGCGTAAAGCG ± Lactobacillaceae; Lactobacillus AGCGCAGGCGGAAGAATAAGTCTGATGTGAAAGCCCTCGGCTT 0.02 AACCGAGGAACTGCATCGGAAACTGTTTTTCTTGAGTGCAGAAG AGGAGAATGGAACTCCATGTGTAGCGGTGGAATGCGTAGATATA TGGAAGAACACCAGTGGCGAAGGCGGCTCTCTGGTCTGCAACT GACGCTGAGGCTCGAAAGCATGGGTAGCGAACAGG 49 195574 0.10 Bacteroidetes; Bacteroidia; TACGGAAGGTCCGGGCGTTATCCGGATTTATTGGGTTTAAAGGG ± Gacteroidales; Prevotellaceae; AGCGTAGGCCGGAGATTAAGCGTGTTGTGAAATGTAGAGGCTC 0.02 Prevotella AACCTCTGCACTGCAGCGCGAACTGGTCTTCTTGAGTACGCACA ACGTGGGCGGAATTCGTGGTGTAGCGGTGAAATGCTTAGATATC ACGAAGAACTCCGATTGCGAAGGCAGCTCACGGGAGCGCAACT GACGCTGAAGCTCGAAAGTGCGGGTATCGAACAGG 50 365047 0.10 Firmicutes; Clostridia; Clostridiales; TACGTAGGGGGCAAGCGTTATCCGGATTTACTGGGTGTAAAGG ± Ruminococcaceae; Ruminococcus; GAGCGTAGACGGTGTGGCAAGTCTGATGTGAAAGGCATGGGCT 0.03 Ruminococcus_sp_5_1_39BFAA CAACCTGTGGACTGCATTGGAAACTGTCATACTTGAGTGCCGGA GGGGTAAGCGGAATTCCTAGTGTAGCGGTGAAATGCGTAGATAT TAGGAGGAACACCAGTGGCGAAGGCGGCTTACTGGACGGTAAC TGACGTTGAGGCTCGAAAGCGTGGGTAGCAAACAGG 51 471308 0.09 Firmicutes; Bacilli; Lactobacillales; TACGTAGGTGGCAGGCGTTGTCCGGATTTATTGGGCGTAAAGG ± Lactobacillaceae; Lactobacillus; GAACGCAGGCGGTCTTTTAAGTCTGATGTGAAAGCCTTCGGCTT 0.03 Lactobacillus_ruminis AACCGAAGTAGTGCATTGGAAACTGGAAGACTTGAGTGCAGAAG AGGAGAGTGGAGCTCCATGTGTAGCGGTGAAATGCGTAGATATA TGGAAGAACACCAGTGGCGAAAGCGGCTCTCTGGTCTGTAACT GACGCTGAGGTTCGAAAGCGTGGGTAGCAAACAGG 52 307981 0.09 Proteobacteria; Gammaproteobacteria; TACGGAGGGTGCAAGCGTTAATCGGAATTACTGGGCGTAAAGC ± Enterobacteriales; GCACGCAGGCGGTTTGTTAAGTCAGATGTGAAATCCCCGGGCT 0.03 Enterobacteriaceae CAACCTGGGAACTGCATCTGATACTGGCAAGCTTGAGTCTCGTA GAGGGGGGTAGAATTCCAGGTGTAGCGGTGAAATGCGTAGAGA TCTGGAGGAATACCGGTGGCGAAGGCGGCCCCCTGGACAAAGA CTGACGCTCAGGTGCGAAAGCGTGGGGAGCAAACAGG 53 15382 0.08 Firmicutes; Bacilli; Lactobacillales; TACGTAGGTCCCGAGCGTTGTCCGGATTTATTGGGCGTAAAGCG ± Streptococcaceae; Streptococcus AGCGCAGGCGGTTTGATAAGTCTGAAGTTAAAGGCTGTGGCTCA 0.02 ACCATAGTTCGCTTTGGAAACTGTCAAACTTGAGTGCAGAAGGG GAGAGTGGAATTCCATGTGTAGCGGTGAAATGCGTAGATATATG GAGGAACACCGGTGGCGAAAGCGGCTCTCTGGTCTGTAACTGA CGCTGAGGCTCGAAAGCGTGGGGAGCAAACAGG 54 302844 0.08 Firmicutes; Clostridia; Clostridiales; TACGTAGGTGGCGAGCGTTGTCCGGATTTACTGGGCGTAAAGG ± Clostridiaceae; Clostridium; GAGCGTAGGCGGACTTTTAAGTGAGATGTGAAATACCCGGGCT 0.02 Clostridium_disporicum; CAACTTGGGTGCTGCATTTCAAACTGGAAGTCTAGAGTGCAGGA GAGGAGAATGGAATTCCTAGTGTAGCGGTGAAATGCGTAGAGAT TAGGAAGAACACCAGTGGCGAAGGCGATTCTCTGGACTGTAACT GACGCTGAGGCTCGAAAGCGTGGGGAGCAAACAGG 55 528842 0.08 Firmicutes; Bacilli; Lactobacillales; TACGTAGGTCCCGAGCGTTATCCGGATTTATTGGGCGTAAAGCG ± Streptococcaceae; Streptococcus; AGCGCAGGCGGTTAGATAAGTCTGAAGTTAAAGGCTGTGGCTTA 0.02 Streptococcus_parasanguinis ACCATAGTACGCTTTGGAAACTGTTTAACTTGAGTGCAGAAGGG GAGAGTGGAATTCCATGTGTAGCGGTGAAATGCGTAGATATATG GAGGAACACCGGTGGCGAAAGCGGCTCTCTGGTCTGTAACTGA CGCTGAGGCTCGAAAGCGTGGGGAGCAAACAGG 56 131391 0.08 Actinobacteria; 1760; Bifidobacteriales; TACGTAGGTCCCGAGCGTTGTCCGGATTTATTGGGCGTAAAGG ± Bifidobacteriaceae; GCTCGTAGGCGGTTCGTCGCGTCCGGTGTGAAAGTCCATCGCT 0.03 Bifidobacterium TAACGGTGGATCCGCGCCGGGTACGGGCGGGCTTGAGTGCGG TAGGGGAGACTGGAATTCCCGGTGTAACGGTGGAATGTGTAGA TATCGGGAAGAACACCAATGGCGAAGGCAGGTCTCTGGGCCGT TACTGACGCTGAGGAGCGAAAGCGTGGGGAGCGAACAGG 57 259261 0.08 Firmicutes; Negativicutes; TACGTAGGCGGCAAGCGTTGTCCGGAATTATTGGGCGTAAAGG ± Selenomonadales; Veillonellaceae; GAGCGCAGGCGGGAAACTAAGCGGATCTTAAAAGTGCGGGGCT 0.02 Megamonas CAACCCCGTGATGGGGTCCGAACTGGTTTTCTTGAGTGCAGGA GAGGAAAGCGGAATTCCCAGTGTAGCGGTGAAATGCGTAGATAT TGGGAAGAACACCAGTGGCGAAGGCGGCTTTCTGGACTGTAAC TGACGCTGAGGCTCGAAAGCTAGGGTAGCGAACGGG 58 248563 0.08 Firmicutes; Clostridia; Clostridiales; TACGTAGGTGGCGAGCGTTGTCCGGATTTACTGGGCGTAAAGG ± Clostridiaceae; Clostridium GAGCGTAGGCGGATTTTTAAGTGAGATGTGAAATACTCGGGCTT 0.02 AACCTGAGTGCTGCATTTCAAACTGGAAGTCTAGAGTGCAGGAG AGGAGAAGGGAATTCCTAGTGTAGCGGTGAAATGCGTAGAGATT AGGAAGAACACCAGTGGCGAAGGCGCTTCTCTGGACTGTAACT GACGCTGAGGCTCGAAAGCGTGGGGAGCAAACAGG 59 162427 0.08 Firmicutes; Negativicutes; TACGTAGGTGGCAAGCGTTGTCCGGAATTATTGGGCGTAAAGG ± Selenomonadales; Veillonellaceae; GCGCGCAGGCGGCATCGCAAGTCGGTCTTAAAAGTGCGGGGCT 0.02 Megasphaera TAACCCCGTGAGGGGACCGAAACTGTGAAGCTCGAGTGTCGGA GAGGAAAGCGGAATTCCTAGTGTAGCGGTGAAATGCGTAGATAT TAGGAGGAACACCAGTGGCGAAAGCGGCTTTCTGGACGACAAC TGACGCTGAGGCGCGAAAGCCAGGGGAGCAAACGGG 60 545371 0.07 Firmicutes; Bacilli; Lactobacillales; TACGTAGGTGGCAAGCGTTGTCCGGATTTATTGGGCGTAAAGCG ± Lactobacillaceae; Lactobacillus AGCGCAGGCGGAAAGATAAGTCTGAAGTGAAAGCCCCCGGCTT 0.01 AACCGGGGAACTGCTTCGGAAACTGTCCTTCTTGAGTGCAGAAG AGGAGAGTGGAACTCCATGTGTAGCGGTGGAATGCGTAGATATA TGGAAGAACACCAGTGGCGAAGGCGGCTCTCTGGTCTGCAACT GACGCTGAGGCTCGAAAGCATGGGTAGCGAACAGG The larger the age-discriminatory importance score the more important the indicated taxon is for age discrimination (determined by permutation using unscaled feature importance scores)

TABLE 6 Associations between relative microbiota maturity, Microbiota-for-Age Z-score and age-adjusted Shannon Diversity Index (SDI) with clinical and dietary parameters in the healthy twins and triplets birth cohort (a) Relative microbiota maturity Effect size on relative microbiota Standard Factor maturity Error p-value diarrhoea −1.98 0.51 0.0001 Month following diarrhoea −1.55 0.56 0.01 Formula +0.75 0.34 0.03 Antibiotics −0.42 0.39 0.27 Chronologic Age (months) −0.05 0.02 0.06 Log-likelihood Degrees of ratio Freedom p-value random by-family intercepts 102.1 1 p < 0.0001 nested random by-child 3.29E−07 1 0.9995 intercepts within family- intercepts (b) MAZ score Effect size Standard Factor on MAZ Error p-value diarrhoea −0.60 0.16 0.0002 Month following diarrhoea −0.42 0.18 0.02 Formula +0.22 0.11 0.04 Antibiotics −0.08 0.12 0.52 Chronologic Age (months) −0.04 0.01 <0.001 Log-likelihood Degrees of ratio Freedom p-value random by-family intercepts 102.1 1 <0.0001 nested random by-child 3.29E−07 1 0.9995 intercepts within family- intercepts (c) Age-adjusted Shannon Diversity Index Effect size Standard Factor on ΔSDI: Error p-value diarrhoea −0.44 0.15 0.0028 Month following diarrhoea −0.37 0.16 0.0247 Formula +0.11 0.10 0.2796 Antibiotics −0.08 0.11 0.3987 Chronologic Age (months) +0.01 0.01 0.296 Log-likelihood Degrees of ratio Freedom p-value random by-family intercepts 53.8 1 <.0001 nested random by-child 1.31 1 0.2515 intercepts within family- intercepts

TABLE 7 Identification of factors affecting variance in fecal microbiota configuration of healthy twins and triplets Hellinger Distance Metric Unweighted UniFrac Distance Metric SumsOf SumsOf Factor Sqs MeanSqs F. Model R² p-value Sqs MeanSqs F. Model R² p-value Chronologic Age 0.6212 0.6212 108.364 0.19033 0.001 0.79963 0.79963 290.79 0.37721 0.001 Diet at time Breastmilk 0.0549 0.0549 9.568 0.01681 0.001 0.03117 0.03117 11.336 0.01471 0.052 of fecal Formula 0.0049 0.0049 0.848 0.00149 0.88 0.00939 0.00939 3.415 0.00443 0.184 sample Solid foods 0.0205 0.0205 3.584 0.00629 0.08 0.03922 0.03922 14.263 0.0185 0.001 collection diarrhoea 0.01 0.01 1.681 0.00295 0.18 0.01255 0.01255 4.563 0.00592 0.006 Antibiotic Usage 0.002 0.002 0.294 0.00052 0.88 0.00421 0.00421 1.533 0.00199 0.154 PERMANOVA was implemented using the R vegan package's ‘adonis function’. We tested for significant associations in a linear model between microbiota variation (as measured by Hellinger or unweighted Unifrac metrics) and the indicated factors. Permutations were constrained within each twin-pair and the set of triplets and interactions between factors were not considered.

TABLE 8 Bacterial taxa enriched in the gut microbiota of Bangladeshi mothers during the first post-partum month compared to subsequent months 2-12 Rank order of Relative Relative importance in 16S rRNA abundance abundance Random Forests- OTU ID (as (%) during (%) during FDR- based age- shown in first month subsequent corrected Beta discriminatory RDP 2.4 Taxonomic Annotation FIG. 2B) post-partum¹ months p value Coefficient² model (Phylum; Class; Order; Family; Genus; Species) 469873 12.27 ± 4.91  2.08 ± 0.45 0.033 +0.148 22 Actinobacteria; 1760; Bifidobacteriales; Bifidobacteriaceae; Bifidobacterium 72820 7.70 ± 3.33 0.64 ± 0.14 0.001 +0.13 5 Actinobacteria; 1760; Bifidobacteriales; Bifidobacteriaceae; Bifidobacterium; Bifidobacterium_longum 348374 0.62 ± 0.60 0.00 ± 0.00 0.012 +0.028 Bacteroidetes; Bacteroidia; Bacteroidales; Bacteroidaceae; Bacteroides; Bacteroides_thetaiotaomicron 158660 0.54 ± 0.46 0.02 ± 0.01 0.037 +0.025 Bacteroidetes; Bacteroidia; Bacteroidales; Bacteroidaceae; Bacteroides 194648 0.40 ± 0.13 0.11 ± 0.01 0.020 +0.024 Firmicutes; Clostridia; Clostridiales; unclassified_Clostridiales; Blautia; Blautia_sp_M25 528842 0.29 ± 0.26 0.02 ± 0.00 0.006 +0.023 Firmicutes; Bacilli; Lactobacillales; Streptococcaceae; Streptococcus; Streptococcus_parasanguinis 561483 0.15 ± 0.07 0.01 ± 0.00 <0.0001 +0.019 8 Actinobacteria; 1760; Bifidobacteriales; Bifidobacteriaceae; Bifidobacterium 113558 0.19 ± 0.12 0.02 ± 0.00 0.027 +0.018 Proteobacteria; Gammaproteobacteria; Enterobacteriales; Enterobacteriaceae 122816 0.16 ± 0.15 0.00 ± 0.00 0.007 +0.014 Proteobacteria; Gammaproteobacteria; Enterobacteriales; Enterobacteriaceae; Morganella; Morganella_morganii 259130 0.10 ± 0.09 0.00 ± 0.00 0.012 +0.011 Firmicutes; Clostridia; Clostridiales; Eubacteriaceae; Eubacterium; Eubacterium_limosum 259422 0.06 ± 0.05 0.00 ± 0.00 0.012 +0.008 Firmicutes; Bacilli; Lactobacillales; Lactobacillaceae; Lactobacillus 192132 0.04 ± 0.03 0.00 ± 0.00 0.024 +0.007 Proteobacteria; Deltaproteobacteria; Desulfovibrionales; Desulfovibrionaceae; Bilophila; Bilophila_wadsworthia 44126 0.03 ± 0.02 0.00 ± 0.00 0.012 +0.007 Firmicutes; Bacilli; Lactobacillales; Enterococcaceae; Enterococcus ¹Mean values ± SEM are shown ²Beta-coefficient is the measure of effect size in linear mixed models used to identify maternally-enriched taxa during the first post-partum month

TABLE 9 Metadata for Bangladeshi children with SAM in a randomized clinical trial of RUTF versus Khichuri-Halwa Months Age at Duration of WHZ at end Rate of followed Food beginning of food of food weight gain Enteropathogens during post WHZ at Intervention intervention intervention intervention (g/kg body detected at intervention Child ID Gender enrollment Assignment (months) (days)¹ phase weight/day) enrollment period Bgmal1 Male −5.22 RUTF 7.43 28 −2.97 2.12 none detected 5.53 Bgmal5 Male edema RUTF 10.87 21 −4.18 8.07 none detected 5.97 Bgmal6 Male −4 RUTF 11.7 17 −2.75 10.69 none detected lost to follow-up Bgmal7 Female −3.92 RUTF 10.3 27 −2.72 12.47 none detected 3.04 Bgmal9 Female −3.76 RUTF 11.27 8 −3.02 5.18 not done lost to follow-up Bgmal13 Female −3.51 RUTF 6.67 3 (LAMA) −3.78 4.63 none detected lost to follow-up Bgmal14 Male −4.17 RUTF 14.2 17 −2.79 8.31 Vibrio cholerae lost to follow-up Bgmal15 Male −4.03 RUTF 17.37 8 −2.49 17.23 none detected 2 Bgmal18 Male −4.6 RUTF 14.97 17 −3.67 4.76 none detected 1.1 Bgmal20 Female −3.38 RUTF 10.67 9 (LAMA) −3.32 11.13 Shigella flexneri lost to follow-up Bgmal22 Male −3.35 RUTF 9.27 8 −3.31 4.75 not done 6.17 Bgmal25 Male −3.38 RUTF 6.77 18 −2.25 7.82 none detected 6 Bgmal26 Male −4.97 RUTF NA 3 (LAMA) −5.23 16.2 none detected lost to follow-up Bgmal27 Male −4.91 RUTF 9.07 16 −3.75 15.98 none detected lost to follow-up Bgmal29 Male −4.07 RUTF 10.47 8 −2.63 16.87 none detected 0.13 Bgmal33 Female −4.86 RUTF 8.33 21 −3.23 11.6 none detected 3.93 Bgmal34 Male −4.73 RUTF 16.6 17 −3.3 14.7 none detected 3.04 Bgmal35 Male −5.28 RUTF 7.87 15 −3.92 12.3 not done 4.9 Bgmal38 Male −4.66 RUTF 14.13 1 (LAMA) −4.66 no weight none detected lost to follow-up gain Bgmal41 Female −3.39 RUTF 18.8 17 −2.33 8.6 Shigella boydi 4.87 Bgmal42 Female −3.4 RUTF 14.6 13 −2.58 10.7 Hafnia alvae lost to follow-up Bgmal43 Male −5.3 RUTF 7.13 14 −4.07 15.3 none detected 5.9 Bgmal44 Male −3.45 RUTF 7.77 14 −2.63 10.1 not done 5.9 Bgmal48 Male −3.3 RUTF 16.1 13 −1.99 8.6 Vibrio cholerae 1.54 Bgmal49 Male −4.09 RUTF 8.73 4 (LAMA) −3.81 15.9 none detected lost to follow-up Bgmal52 Male −5.3 RUTF 12.57 12 (LAMA)  −4.24 4.5 not done lost to follow-up Bgmal54 Female −3.91 RUTF 10.53 14 −3.1 7.4 not done 2.93 Bgmal57 Male −4.24 RUTF 17.33 12 −2.57 13.8 not done 6 Bgmal58 Male −4.29 RUTF 11.07 11 −2.13 17.1 not done 7.27 Bgmal59 Male −4.54 RUTF 14.77 9 −2.75 16.2 not done 6.06 Bgmal61 Male −4.44 RUTF 14.27 13 −3.31 16.69 not done 0.54 Bgmal62 Male −3.51 RUTF 7.33 20 −2.34 6.92 not done 1.5 Bgmal2 Female −4.21 Khichuri-Halwa 12.13 21 −2.72 10.62 none detected lost to follow-up Bgmal3 Male −4.4 Khichuri-Halwa 9.23 17 −3.09 10.1 Vibrio cholerae 3.76 Bgmal4 Male −4.35 Khichuri-Halwa 9.13 29 −3.53 4.85 none detected 1.03 Bgmal8 Female −3.29 Khichuri-Halwa 17.9 18 −1.7 8.57 none detected 2.07 Bgmal10 Male −5.45 Khichuri-Halwa 15.57 13 −3.69 16.48 none detected 1.97 Bgmal11 Male −3.84 Khichuri-Halwa 15.07 16 −3.13 1.95 none detected lost to follow-up Bgmal12 Female −3.48 Khichuri-Halwa 19.77 9 −1.67 13.91 none detected 0.56 Bgmal16 Female −3.94 Khichuri-Halwa 12.73 8 −2.12 16.42 none detected 0.16 Bgmal17 Male −4.2 Khichuri-Halwa na 2 (LAMA) −4.16 3.78 none detected lost to follow-up Bgmal19 Male edema Khichuri-Halwa 7.8 25 −0.09 7.06 Aeromona 1.17 hydrophila Bgmal21 Male −4.76 Khichuri-Halwa 8.83 22 −3.89 3.31 none detected 2.74 Bgmal23 Male −3.15 Khichuri-Halwa 9.97 6 (LAMA) −3.1 4 not done lost to follow-up Bgmal24 Male −4.63 Khichuri-Halwa 8.43 14 −3.94 4.81 Shigella sonnei 0.46 Bgmal28 Female −3.56 Khichuri-Halwa 15.87 18 −2.26 8.89 Shigella flexneri 5.94 Bgmal30 Female −3.35 Khichuri-Halwa 9.2 13 −2.13 11.31 none detected lost to follow-up Bgmal31 Male −4.47 Khichuri-Halwa 13.9 13 −3 12.5 none detected 5.67 Bgmal32 Male −4.54 Khichuri-Halwa 19.9 15 −3.05 11.4 none detected 5.9 Bgmal36 Male −3.96 Khichuri-Halwa 15.37 27 −2.61 5.9 none detected 3.4 Bgmal37 Male −3.37 Khichuri-Halwa 13.13 26 3.01 2.6 none detected 5.43 Bgmal39 Female −5.59 Khichuri-Halwa 14.13 10 −4.93 15.9 Salmonella 9.1 enterica group C1 Bgmal40 Female −4.21 Khichuri-Halwa 10.1 27 −3.76 3.3 not done 5.57 Bgmal45 Male −5.32 Khichuri-Halwa 8.6 26 −4.58 5.6 none detected 5.9 Bgmal46 Female −5.4 Khichuri-Halwa 18.5 15 −4.03 12.3 none detected 3.87 Bgmal47 Female −4.76 Khichuri-Halwa 12.33 10 −3.91 10.8 Shigella flexneri 5.9 Bgmal50 Male −3.79 Khichuri-Halwa 13.97 13 −2.23 12.9 not done 6.03 Bgmal51 Male −4.03 Khichuri-Halwa 14.93 10 −2.22 14.7 Vibrio cholerae 1.96 Bgmal53 Male −4.54 Khichuri-Halwa 14.53 11 −2.76 16.1 not done lost to follow-up Bgmal55 Male −5.58 Khichuri-Halwa 8.4 4 (LAMA) −4.9 23.2 not done lost to follow-up Bgmal56 Male −3.35 Khichuri-Halwa 9 11 −1.87 13.5 not done 7.3 Bgmal60 Male edema Khichuri-Halwa 8.97 15 −0.71 11.7 not done 5.9 Bgmal63 Male −3.02 Khichuri-Halwa 8.47 12 −1.59 14.74 not done 6 Bgmal64 Female −3.1 Khichuri-Halwa 11.17 8 −1.55 19.77 not done 4.5 ¹LAMA—left against medical advice

TABLE 10 Contingency tables relating gender and antibiotics to food-intervention arms in the SAM trial (a) ‘Gender by Food-intervention’ Gender RUTF Khichuri-Halwa Total p value Male 24 21 45 Female 8 11 19 Total 32 32 64 0.59 Antibiotics RUTF Khichuri-Halwa Total p value (b) ‘Antibiotics by Food-intervention’ during nutritional rehabilitation Yes 84 79 163 No 55 90 145 Total 139 169 308 0.02 (c) ‘Antibiotics by Food-intervention’ during the post-intervention follow-up period Yes 22 23 45 No 78 80 158 Total 100 103 203 1 Fisher's Exact test (two-sided) p-value are presented

TABLE 11 Ingredients of foods used during nutritional rehabilitation of children with SAM (a) Khichuri Ingredient Amount in 1 kg khichuri Rice 120 g Lentils (mashur dal) 60 g Oil (soya) 70 ml Potato 100 g Pumpkin 100 g Leafy vegetable (shak) 80 g Onion (2 medium size) 50 g Spices (ginger, garlic, turmeric 50 g and coriander powder) Water 1000 ml Total energy/kg 1,442 kcal Total protein/kg 29.6 g (b) Halwa Ingredient Amount in 1 kg halwa Wheat flour (atta) 200 g Lentils (mashur dal) 100 g Oil (soya) 100 ml Molasses (brown sugar or gur) 125 g Water (to make a thick paste) 600 ml Total energy/kg 2,404 kcal Total protein/kg 50.5 g (c) Milk suji & Milk suji ‘100’ Amount in Amount in Ingredient 1 L Milk Suji 1 L Milk Suji ‘100’ Whole milk powder (g) 40 80 Rice powder (g) 40 50 Sugar (g) 25 50 Soya oil (g) 25 25 MgCl₂ (g) 0.5 0.5 KCl (g) 1 1 Calcium lactate/calcium 2 2 carbonate (g) Total energy/L 670 kcal  1000 kcal Total protein/L 14 g   26 g (d) RUTF (Plumpy Nut)¹ Ingredient Amount in 1 kg RUTF Skimmed milk powder 300 g Sugar 280 g Vegetable oil 154 g Peanut paste 250 g Mineral vitamin mix 16 g Total energy/kg 5300-5450 kcal Total protein/kg 136 g ¹Formulation complies with the WHO macro- and micronutrient profile requirements for RUTF.

TABLE 12 Relative microbiota maturity, Microbiota-for-Age Z-score and Age-adjusted Shannon Diversity Index comparisons in each treatment phase of each intervention arm in the SAM trial (compared to healthy controls and to values at enrollment) Intervention Std. p Arm Estimate Error value (a) Effect size and significance of differences in microbiota maturation metrics between each treatment phase relative to healthy children Relative microbiota maturity Enrollment RUTF −5.62 0.78 <0.001 During −5.09 0.68 <0.001 End of Intervention −4.75 0.82 <0.001  <1 month −2.85 0.83 <0.01 1-2 months −2.19 0.87 0.07 2-3 months −0.31 1.03 1.00 3-4 months −1.96 1.11 0.35  >4 months −3.43 0.96 <0.01 Enrollment Khichuri- −6.55 0.67 <0.001 During Halwa −5.88 0.53 <0.001 End of Intervention −5.63 0.72 <0.001  <1 month −3.98 0.74 <0.001 1-2 months −1.72 0.79 0.18 2-3 months −2.67 0.89 0.02 3-4 months −1.58 1.05 0.59  >4 months −2.29 0.82 0.04 Microbiota-for- Age Z-score Enrollment RUTF −1.63 0.26 <0.001 During −1.49 0.23 <0.001 End of Intervention −1.39 0.27 <0.001  <1 month −0.84 0.27 0.01 1-2 months −0.75 0.28 0.04 2-3 months −0.42 0.33 0.68 3-4 months −0.73 0.35 0.19  >4 months −1.43 0.31 <0.001 Enrollment Khichuri- −1.80 0.23 <0.001 During Halwa −1.68 0.19 <0.001 End of Intervention −1.66 0.24 <0.001  <1 month −1.30 0.25 <0.001 1-2 months −0.69 0.26 0.06 2-3 months −1.05 0.29 <0.01 3-4 months −0.56 0.34 0.46  >4 months −0.96 0.27 <0.01 Age-Adjusted Shannon Diversity Index Enrollment RUTF −1.18 0.16 <0.001 During −0.82 0.12 <0.001 End of Intervention −0.89 0.17 <0.001  <1 month −0.56 0.18 0.01 1-2 months −0.30 0.19 0.55 2-3 months −0.46 0.24 0.32 3-4 months −1.18 0.26 <0.001  >4 months −0.79 0.22 <0.01 Enrollment Khichuri- −1.03 0.15 <0.001 During Halwa −0.95 0.11 <0.001 End of Intervention −0.90 0.16 <0.001  <1 month −0.83 0.17 <0.001 1-2 months −0.89 0.18 <0.001 2-3 months −0.73 0.21 <0.01 3-4 months −0.41 0.25 0.54  >4 months −0.58 0.19 0.02 (b) Effect size and significance of differences in microbiota maturation metrics between each treatment phase relative to enrollment Relative microbiota maturity Healthy RUTF 5.62 0.78 <0.001 During 0.53 0.57 0.93 End of Intervention 0.87 0.73 0.80  <1 month 2.77 0.74 <0.01 1-2 months 3.44 0.78 <0.001 2-3 months 5.31 0.96 <0.001 3-4 months 3.67 1.05 <0.01  >4 months 2.20 0.88 0.08 Healthy Khichuri- 6.55 0.67 <0.001 During Halwa 0.67 0.56 0.79 End of Intervention 0.92 0.74 0.76  <1 month 2.58 0.76 <0.01 1-2 months 4.83 0.81 <0.001 2-3 months 3.88 0.91 <0.001 3-4 months 4.97 1.07 <0.001  >4 months 4.27 0.84 <0.001 Microbiota-for- Age Z-score Healthy RUTF 1.63 0.26 <0.001 During 0.13 0.17 0.98 End of Intervention 0.24 0.22 0.88  <1 month 0.79 0.23 <0.01 1-2 months 0.88 0.24 <0.01 2-3 months 1.21 0.30 <0.001 3-4 months 0.90 0.32 0.036  >4 months 0.20 0.27 0.98 Healthy Khichuri- 1.80 0.23 <0.001 During Halwa 0.12 0.17 0.99 End of Intervention 0.14 0.23 0.99  <1 month 0.50 0.24 0.20 1-2 months 1.11 0.25 <0.001 2-3 months 0.75 0.28 0.05 3-4 months 1.24 0.33 0.001  >4 months 0.84 0.26 0.01 Age- adjusted Shannon Diversity Index Healthy RUTF 1.18 0.16 <0.001 During 0.36 0.15 0.11 End of Intervention 0.29 0.19 0.56  <1 month 0.62 0.20 0.01 1-2 months 0.88 0.21 <0.001 2-3 months 0.72 0.26 0.03 3-4 months 0.00 0.28 1.00  >4 months 0.39 0.23 0.46 Healthy Khichuri- 1.03 0.15 <0.001 During Halwa 0.07 0.14 1.00 End of Intervention 0.12 0.18 0.99  <1 month 0.19 0.19 0.89 1-2 months 0.13 0.20 0.99 2-3 months 0.30 0.23 0.70 3-4 months 0.62 0.27 0.12  >4 months 0.45 0.21 0.18 Estimates of beta coefficients, standard error and p-values from Dunnett's post-hoc comparisons between treatment phases for each intervention arm of linear mixed models with random by-child intercepts Samples associated with diarrhoea in healthy reference controls were not considered as suitable controls and excluded from comparisons

TABLE 13 220 bacterial taxa whose abundances are significantly altered in the microbiota of children with SAM compared to similarly aged healthy children Rank order of importance in Random 16S rRNA Unabbreviated FDR- Forests- OTU ID OTU ID in cor- Beta based age- (as shown in deposited rected Coeffi- discriminatory RDP 2.4 Taxonomic Annotation FIG. 8 & 9) OTU table p value cient model (Phylum; Class; Order; Family; Genus; Species) (a) Taxa altered in children with SAM relative to healthy controls at enrollment prior to intervention phase 142054 142054 0.000 0.0286 Proteobacteria; Gammaproteobacteria; Enterobacteriales; Enterobacteriaceae 210269 210269 0.000 0.0278 Proteobacteria; Gammaproteobacteria; Enterobacteriales; Enterobacteriaceae 9715 9715 0.000 0.0263 Proteobacteria; Gammaproteobacteria; Enterobacteriales; Enterobacteriaceae 563485 563485 0.002 0.0236 Proteobacteria; Gammaproteobacteria; Enterobacteriales; Enterobacteriaceae 436723 436723 0.000 0.0232 Proteobacteria; Gammaproteobacteria; Enterobacteriales; Enterobacteriaceae 512914 512914 0.000 0.0215 Proteobacteria; Gammaproteobacteria; Enterobacteriales; Enterobacteriaceae 310265 310265 0.000 0.0207 Proteobacteria; Gammaproteobacteria; Enterobacteriales; Enterobacteriaceae 307981 307981 0.000 0.0174 Proteobacteria; Gammaproteobacteria; Enterobacteriales; Enterobacteriaceae 307080 307080 0.000 0.0152 Proteobacteria; Gammaproteobacteria; Enterobacteriales; Enterobacteriaceae; Escherichia 305760 305760 0.000 0.0131 Proteobacteria; Gammaproteobacteria; Enterobacteriales; Enterobacteriaceae; Escherichia; Escherichia_coli 113558 113558 0.000 0.0115 Proteobacteria; Gammaproteobacteria; Enterobacteriales; Enterobacteriaceae 280706 280706 0.000 0.0090 Proteobacteria; Gammaproteobacteria; Enterobacteriales; Enterobacteriaceae 540230 540230 0.002 0.0079 Firmicutes; Bacilli; Lactobacillales; Enterococcaceae; Enterococcus; Enterococcus_faecalis 15382 15382 0.027 0.0068 Firmicutes; Bacilli; Lactobacillales; Streptococcaceae; Streptococcus 249155.c0 New.0.CleanUp.Refer- 0.027 0.0067 Firmicutes; Bacilli; Lactobacillales; Leuconostocaceae; Leuconostoc enceOTU249155 316587 316587 0.007 0.0063 Firmicutes; Bacilli; Lactobacillales; Streptococcaceae; Streptococcus; Streptococcus_gallolyticus 469852 469852 0.000 −0.0163 Actinobacteria; 1760; Bifidobacteriales; Bifidobacteriaceae; Bifidobacterium; Bifidobacterium_bifidum 533785 533785 0.000 −0.0146 15 Actinobacteria; 1760; Bifidobacteriales; Bifidobacteriaceae; Bifidobacterium 24773 24773 0.000 −0.0137 Actinobacteria; 1760; Bifidobacteriales; Bifidobacteriaceae; Bifidobacterium 326792 326792 0.000 −0.0118 1 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Faecalibacterium; Faecalibacterium_prausnitzii 301004 301004 0.001 −0.0115 Actinobacteria; 1760; Coriobacteriales; Coriobacteriaceae; Olsenella 181834 181834 0.000 −0.0112 20 Firmicutes; Clostridia; Clostridiales; Clostridiaceae; Clostridium 261912 261912 0.000 −0.0109 12 Firmicutes; Clostridia; Clostridiales; Lachnospiraceae; Dorea; Dorea_formicigenerans 13823 13823 0.005 −0.0104 Firmicutes; Negativicutes; Selenomonadales; Veillonellaceae; Veillonella; Veillonella_ratti 188900 188900 0.000 −0.0103 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Faecalibacterium; Faecalibacterium_prausnitzii 187010 187010 0.000 −0.0102 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Faecalibacterium; Faecalibacterium_prausnitzii 131391 131391 0.000 −0.0098 Actinobacteria; 1760; Bifidobacteriales; Bifidobacteriaceae; Bifidobacterium 576.d0 New.0.Refer- 0.001 −0.0097 Actinobacteria; 1760; Coriobacteriales; Coriobacteriaceae enceOTU576 162427 162427 0.020 −0.0096 Firmicutes; Negativicutes; Selenomonadales; Veillonellaceae; Megasphaera 303304 303304 0.000 −0.0094 Bacteroidetes; Bacteroidia; Bacteroidales; Prevotellaceae; Prevotella; Prevotella_copri 470663 470663 0.000 −0.0094 3 Firmicutes; Bacilli; Lactobacillales; Lactobacillaceae; Lactobacillus; Lactobacillus_ruminis 309068 309068 0.000 −0.0093 Bacteroidetes; Bacteroidia; Bacteroidales; Prevotellaceae; Prevotella; Prevotella_copri 186029 186029 0.000 −0.0092 Actinobacteria; 1760; Coriobacteriales; Coriobacteriaceae; Collinsella; Collinsella_aerofaciens 145149 145149 0.001 −0.0090 Firmicutes; Negativicutes; Selenomonadales; Veillonellaceae; Veillonella 130663 130663 0.020 −0.0088 Bacteroidetes; Bacteroidia; Bacteroidales; Bacteroidaceae; Bacteroides; Bacteroides_fragilis 194745 194745 0.000 −0.0088 6 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Ruminococcus; Ruminococcus_sp_5_1_39BFAA 212503 212503 0.000 −0.0088 Firmicutes; Clostridia; Clostridiales; Clostridiaceae; Clostridium 184464 184464 0.001 −0.0085 Bacteroidetes; Bacteroidia; Bacteroidales; Prevotellaceae; Prevotella; Prevotella_copri 89679.c0 New.0.CleanUp.Refer- 0.007 −0.0085 Actinobacteria; 1760; Coriobacteriales; Coriobacteriaceae; Collinsella; enceOTU89679 Collinsella_aerofaciens 274208 274208 0.014 −0.0084 Firmicutes; Negativicutes; Selenomonadales; Veillonellaceae; Megasphaera; Megasphaera_elsdenii 469873 469873 0.000 −0.0081 22 Actinobacteria; 1760; Bifidobacteriales; Bifidobacteriaceae; Bifidobacterium 139221 139221 0.017 −0.0080 Actinobacteria; 1760; Coriobacteriales; Coriobacteriaceae 15141 15141 0.016 −0.0079 7 Firmicutes; Bacilli; Lactobacillales; Lactobacillaceae; Lactobacillus; Lactobacillus_mucosae 364234 364234 0.000 −0.0077 10 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Ruminococcus; Ruminococcus_sp_5_1_39BFAA 198251 198251 0.022 −0.0077 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Ruminococcus; Ruminococcus_gnavus 259261 259261 0.011 −0.0077 Firmicutes; Negativicutes; Selenomonadales; Veillonellaceae; Megamonas 191687 191687 0.000 −0.0076 4 Firmicutes; Clostridia; Clostridiales; Lachnospiraceae; Dorea; Dorea_longicatena 189827 189827 0.000 −0.0073 2 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Ruminococcus; Ruminococcus_sp_5_1_39BFAA 292302 292302 0.002 −0.0072 Firmicutes; Bacilli; Lactobacillales; Lactobacillaceae; Lactobacillus 365047 365047 0.000 −0.0072 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Ruminococcus; Ruminococcus_sp_5_1_39BFAA 250395 250395 0.000 −0.0072 Firmicutes; Bacilli; Lactobacillales; Lactobacillaceae; Lactobacillus 258806.c0 New.0.CleanUp.Refer- 0.005 −0.0071 Actinobacteria; 1760; Coriobacteriales; Coriobacteriaceae enceOTU258806 326977 326977 0.000 −0.0070 Actinobacteria; 1760; Bifidobacteriales; Bifidobacteriaceae; Bifidobacterium 165261 165261 0.005 −0.0069 Firmicutes; Clostridia; Clostridiales; Clostridiaceae; Clostridium 370431 370431 0.003 −0.0068 Actinobacteria; 1760; Actinomycetales; Actinomycetaceae; Actinomyces; Actinomyces_odontolyticus 2000 2000 0.038 −0.0068 Bacteroidetes; Bacteroidia; Bacteroidales; Bacteroidaceae; Bacteroides; Bacteroides_fragilis 561483 561483 0.006 −0.0067 8 Actinobacteria; 1760; Bifidobacteriales; Bifidobacteriaceae; Bifidobacterium 177351 177351 0.004 −0.0064 Bacteroidetes; Bacteroidia; Bacteroidales; Prevotellaceae; Prevotella 72820 72820 0.005 −0.0064 5 Actinobacteria; 1760; Bifidobacteriales; Bifidobacteriaceae; Bifidobacterium; Bifidobacterium_longum 58262 58262 0.012 −0.0064 Firmicutes; Negativicutes; Selenomonadales; Veillonellaceae; Allisonella; Allisonella_histaminiformans 212619 212619 0.000 −0.0063 24 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae 142448 142448 0.006 −0.0060 Firmicutes; Bacilli; Lactobacillales; Lactobacillaceae; Lactobacillus 48207 48207 0.001 −0.0060 Firmicutes; Negativicutes; Selenomonadales; Veillonellaceae; Dialister 158660 158660 0.038 −0.0059 Bacteroidetes; Bacteroidia; Bacteroidales; Bacteroidaceae; Bacteroides 195574 195574 0.005 −0.0059 Bacteroidetes; Bacteroidia; Bacteroidales; Prevotellaceae; Prevotella 28727 28727 0.009 −0.0059 Firmicutes; Bacilli; Lactobacillales; Lactobacillaceae; Lactobacillus 170124 170124 0.000 −0.0057 Firmicutes; Clostridia; Clostridiales; Eubacteriaceae; Eubacterium; Eubacterium_desmolans 11372 11372 0.019 −0.0057 Actinobacteria; 1760; Coriobacteriales; Coriobacteriaceae; Eggerthella; Eggerthella_lenta 365758 365758 0.003 −0.0057 Bacteroidetes; Bacteroidia; Bacteroidales; Prevotellaceae; Prevotella 361809 361809 0.000 −0.0056 13 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Ruminococcus; Ruminococcus_torques 287510 287510 0.000 −0.0055 11 Firmicutes; Erysipelotrichi; Erysipelotrichales; Erysipelotrichaceae; Catenibacterium; Catenibacterium_mitsuokai 177005 177005 0.000 −0.0054 Firmicutes; Clostridia; Clostridiales 185951 185951 0.000 −0.0054 23 Firmicutes; Clostridia; Clostridiales 73.d0 New.0.Refer- 0.026 −0.0054 Firmicutes; Bacilli; Lactobacillales; Lactobacillaceae enceOTU73 155355.c0 New.0.CleanUp.Refer- 0.045 −0.0052 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Faecalibacterium enceOTU155355 325969 325969 0.002 −0.0051 Firmicutes; Clostridia; Clostridiales; Clostridiaceae; Clostridium; Clostridium_sp_SS2_1 268604 268604 0.016 −0.0050 Bacteroidetes; Bacteroidia; Bacteroidales; Prevotellaceae; Prevotella 182804 182804 0.000 −0.0050 Actinobacteria; 1760; Coriobacteriales; Coriobacteriaceae 71685 71685 0.006 −0.0049 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Ruminococcus; Ruminococcus_torques 181003 181003 0.001 −0.0048 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Ruminococcus 266274 266274 0.007 −0.0047 Firmicutes; Clostridia; Clostridiales 198941 198941 0.004 −0.0045 Firmicutes; Clostridia; Clostridiales; Eubacteriaceae; Eubacterium; Eubacterium_desmolans 470477 470477 0.009 −0.0044 Firmicutes; Bacilli; Lactobacillales; Carnobacteriaceae; Granulicatella; Granulicatella_adiacens 184037 184037 0.004 −0.0044 Firmicutes; Clostridia; Clostridiales; Clostridiaceae; Clostridium; Clostridium_sp_SS2_1 325608 325608 0.003 −0.0044 Firmicutes; Clostridia; Clostridiales; Clostridiaceae; Clostridium; Clostridium_bartlettii 367433 367433 0.009 −0.0044 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Faecalibacterium; Faecalibacterium_prausnitzii 517331 517331 0.006 −0.0043 Bacteroidetes; Bacteroidia; Bacteroidales; Prevotellaceae; Prevotella 302844 302844 0.015 −0.0042 Firmicutes; Clostridia; Clostridiales; Clostridiaceae; Clostridium; Clostridium_disporicum 189396 189396 0.019 −0.0042 Firmicutes; Clostridia; Clostridiales; Lachnospiraceae; Coprococcus; Coprococcus_comes 24916 24916 0.019 −0.0042 Bacteroidetes; Bacteroidia; Bacteroidales; Prevotellaceae; Prevotella 369164 369164 0.007 −0.0040 Firmicutes; Clostridia; Clostridiales 191306 191306 0.003 −0.0039 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Ruminococcus; Ruminococcus_sp_5_1_39BFAA 9514 9514 0.011 −0.0038 16 Proteobacteria; Gammaproteobacteria; Pasteurellales; Pasteurellaceae; Haemophilus; Haemophilus_parainfluenzae 470369 470369 0.009 −0.0038 Firmicutes; Erysipelotrichi; Erysipelotrichales; Erysipelotrichaceae; unclassified_Erysipelotrichaceae; Eubacterium_biforme 295024 295024 0.009 −0.0037 Firmicutes; Erysipelotrichi; Erysipelotrichales; Erysipelotrichaceae; unclassified_Erysipelotrichaceae; Eubacterium_biforme 185281 185281 0.009 −0.0037 Firmicutes; Clostridia; Clostridiales 579564 579564 0.039 −0.0036 Firmicutes; Clostridia; Clostridiales; Clostridiaceae; Clostridium; Clostridium_disporicum 178146 178146 0.019 −0.0034 Firmicutes; Clostridia; Clostridiales; Eubacteriaceae; Eubacterium; Eubacterium_hallii 199293 199293 0.005 −0.0033 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Faecalibacterium; Faecalibacterium_prausnitzii 177772 177772 0.009 −0.0032 Firmicutes; Clostridia; Clostridiales; Eubacteriaceae; Eubacterium; Eubacterium_rectale 174256 174256 0.016 −0.0031 Firmicutes; Clostridia; Clostridiales; Eubacteriaceae; Eubacterium; Eubacterium_hallii 182994 182994 0.034 −0.0031 Firmicutes; Clostridia; Clostridiales; Eubacteriaceae; Eubacterium; Eubacterium_rectale 179460 179460 0.042 −0.0030 Firmicutes; Clostridia; Clostridiales; Clostridiaceae; Clostridium 212304 212304 0.017 −0.0029 Firmicutes; Clostridia; Clostridiales 594084 594084 0.001 −0.0029 Actinobacteria; 1760; Coriobacteriales; Coriobacteriaceae; Slackia; Slackia_isoflavoniconvertens 175682 175682 0.019 −0.0028 Firmicutes; Clostridia; Clostridiales; Eubacteriaceae; Eubacterium; Eubacterium_rectale 325738 325738 0.049 −0.0027 Bacteroidetes; Bacteroidia; Bacteroidales; Bacteroidaceae; Bacteroides; Bacteroides_galacturonicus 178122 178122 0.007 −0.0027 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Ruminococcus; Ruminococcus_obeum 182202 182202 0.036 −0.0026 Firmicutes; Clostridia; Clostridiales; Clostridiaceae; Clostridium; Clostridium_glycolicum 168716 168716 0.025 −0.0026 Firmicutes; Clostridia; Clostridiales 206931 206931 0.014 −0.0025 Firmicutes; Clostridia; Clostridiales 560141 560141 0.011 −0.0023 Actinobacteria; 1760; Coriobacteriales; Coriobacteriaceae 212787 212787 0.030 −0.0022 Firmicutes; Clostridia; Clostridiales 100258 100258 0.026 −0.0021 Firmicutes; Clostridia; Clostridiales; Eubacteriaceae; Eubacterium; Eubacterium_sp_cL_10_1_3 194648 194648 0.038 −0.0018 Firmicutes; Clostridia; Clostridiales; unclassified_Clostridiales; Blautia; Blautia_sp_M25 471180 471180 0.027 −0.0017 Actinobacteria; 1760; Bifidobacteriales; Bifidobacteriaceae; Bifidobacterium (b) Taxa altered in children with SAM relative to healthy controls during the post-intervention period 292424 292424 0.0000 0.0105 Firmicutes; Bacilli; Lactobacillales; Streptococcaceae; Streptococcus 148099 148099 0.0000 0.0101 21 Firmicutes; Bacilli; Lactobacillales; Leuconostocaceae; Weissella; Weissella_cibaria 249155.c0 New.0.CleanUp.Refer- 0.0035 0.0100 Firmicutes; Bacilli; Lactobacillales; Leuconostocaceae; Leuconostoc enceOTU249155 15382 15382 0.0001 0.0096 Firmicutes; Bacilli; Lactobacillales; Streptococcaceae; Streptococcus 628.d0 New.0.Refer- 0.0011 0.0080 Firmicutes; Bacilli; Lactobacillales; Streptococcaceae; Streptococcus enceOTU628 239.d0 New.0.Refer- 0.0045 0.0065 Firmicutes; Bacilli; Lactobacillales; Lactobacillaceae; Lactobacillus enceOTU239 282068/c0 New.0.CleanUp.Refer- 0.0051 0.0063 Firmicutes; Bacilli; Lactobacillales; Lactobacillaceae; Lactobacillus enceOTU282068 528842 528842 0.0029 0.0059 Firmicutes; Bacilli; Lactobacillales; Streptococcaceae; Streptococcus; Streptococcus_parasanguinis 108747 108747 0.0018 0.0057 14 Firmicutes; Bacilli; Lactobacillales; Streptococcaceae; Streptococcus; Streptococcus_thermophilus 340.d0 New.0.Refer- 0.0043 0.0055 Actinobacteria; 1760; Bifidobacteriales; Bifidobacteriaceae; Bifidobacterium enceOTU340 73.d0 New.0.Refer- 0.0417 0.0054 Firmicutes; Bacilli; Lactobacillales; Lactobacillaceae enceOTU73 294794 294794 0.0173 0.0045 Firmicutes; Bacilli; Lactobacillales; Streptococcaceae; Streptococcus 233573 233573 0.0172 0.0006 Firmicutes; Erysipelotrichi; Erysipelotrichales; Erysipelotrichaceae 326792 326792 0.0000 −0.0136 1 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Faecalibacterium; Faecalibacterium_prausnitzii 181834 181834 0.0000 −0.0126 20 Firmicutes; Clostridia; Clostridiales; Clostridiaceae; Clostridium 187010 187010 0.0000 −0.0114 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Faecalibacterium; Faecalibacterium_prausnitzii 188900 188900 0.0000 −0.0106 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Faecalibacterium; Faecalibacterium_prausnitzii 162427 162427 0.0008 −0.0095 Firmicutes; Negativicutes; Selenomonadales; Veillonellaceae; Megasphaera 533785 533785 0.0008 −0.0093 15 Actinobacteria; 1760; Bifidobacteriales; Bifidobacteriaceae; Bifidobacterium 576.d0 New.0.Refer- 0.0002 −0.0090 Actinobacteria; 1760; Coriobacteriales; Coriobacteriaceae enceOTU576 417.d0 New.0.Refer- 0.0000 −0.0090 Actinobacteria; 1760; Bifidobacteriales; Bifidobacteriaceae; Bifidobacterium enceOTU417 469852 469852 0.0000 −0.0090 Actinobacteria; 1760; Bifidobacteriales; Bifidobacteriaceae; Bifidobacterium; Bifidobacterium_bifidum 212503 212503 0.0000 −0.0089 Firmicutes; Clostridia; Clostridiales; Clostridiaceae; Clostridium 261912 261912 0.0000 −0.0088 12 Firmicutes; Clostridia; Clostridiales; Lachnospiraceae; Dorea; Dorea_formicigenerans 309068 309068 0.0000 −0.0086 Bacteroidetes; Bacteroidia; Bacteroidales; Prevotellaceae; Prevotella; Prevotella_copri 301004 301004 0.0034 −0.0084 Actinobacteria; 1760; Coriobacteriales; Coriobacteriaceae; Olsenella 184464 184464 0.0000 −0.0083 Bacteroidetes; Bacteroidia; Bacteroidales; Prevotellaceae; Prevotella; Prevotella_copri 177351 177351 0.0000 −0.0082 Bacteroidetes; Bacteroidia; Bacteroidales; Prevotellaceae; Prevotella 303304 303304 0.0000 −0.0081 Bacteroidetes; Bacteroidia; Bacteroidales; Prevotellaceae; Prevotella; Prevotella_copri 48207 48207 0.0000 −0.0081 Firmicutes; Negativicutes; Selenomonadales; Veillonellaceae; Dialister 13823 13823 0.0024 −0.0079 Firmicutes; Negativicutes; Selenomonadales; Veillonellaceae; Veillonella; Veillonella_ratti 130663 130663 0.0017 −0.0079 Bacteroidetes; Bacteroidia; Bacteroidales; Bacteroidaceae; Bacteroides; Bacteroides_fragilis 58262 58262 0.0000 −0.0076 Firmicutes; Negativicutes; Selenomonadales; Veillonellaceae; Allisonella; Allisonella_histaminiformans 195574 195574 0.0000 −0.0076 Bacteroidetes; Bacteroidia; Bacteroidales; Prevotellaceae; Prevotella 259261 259261 0.0001 −0.0075 Firmicutes; Negativicutes; Selenomonadales; Veillonellaceae; Megamonas 365758 365758 0.0000 −0.0072 Bacteroidetes; Bacteroidia; Bacteroidales; Prevotellaceae; Prevotella 165261 165261 0.0000 −0.0072 Firmicutes; Clostridia; Clostridiales; Clostridiaceae; Clostridium 212619 212619 0.0000 −0.0069 24 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae 196757 196757 0.0092 −0.0067 Bacteroidetes; Bacteroidia; Bacteroidales; Bacteroidaceae; Bacteroides; Bacteroides_ovatus 181330 181330 0.0000 −0.0067 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Ruminococcus; Ruminococcus_sp_5_1_39BFAA 170124 170124 0.0000 −0.0067 Firmicutes; Clostridia; Clostridiales; Eubacteriaceae; Eubacterium; Eubacterium_desmolans 194745 194745 0.0001 −0.0066 6 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Ruminococcus; Ruminococcus_sp_5_1_39BFAA 189862 189862 0.0046 −0.0066 Bacteroidetes; Bacteroidia; Bacteroidales; Prevotellaceae; Prevotella; Prevotella_sp_DJF_B116 191687 191687 0.0000 −0.0066 4 Firmicutes; Clostridia; Clostridiales; Lachnospiraceae; Dorea; Dorea_longicatena 158660 158660 0.0006 −0.0064 Bacteroidetes; Bacteroidia; Bacteroidales; Bacteroidaceae; Bacteroides 268604 268604 0.0000 −0.0064 Bacteroidetes; Bacteroidia; Bacteroidales; Prevotellaceae; Prevotella 192132 192132 0.0006 −0.0063 Proteobacteria; Deltaproteobacteria; Desulfovibrionales; Desulfovibrionaceae; Bilophila; Bilophila_wadsworthia 274208 274208 0.0172 −0.0062 Firmicutes; Negativicutes; Selenomonadales; Veillonellaceae; Megasphaera; Megasphaera_elsdenii 155355.c0 New.0.CleanUp.Refer- 0.0008 −0.0062 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Faecalibacterium enceOTU155355 266274 266274 0.0000 −0.0061 Firmicutes; Clostridia; Clostridiales 2000 2000 0.0059 −0.0059 Bacteroidetes; Bacteroidia; Bacteroidales; Bacteroidaceae; Bacteroides; Bacteroides_fragilis 331820 331820 0.0043 −0.0058 Bacteroidetes; Bacteroidia; Bacteroidales; Bacteroidaceae; Bacteroides; Bacteroides_vulgatus 364234 364234 0.0000 −0.0057 10 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Ruminococcus; Ruminococcus_sp_5_1_39BFAA 11.d0 New.0.Refer- 0.0305 −0.0057 Firmicutes; Negativicutes; Selenomonadales; Veillonellaceae enceOTU11 198941 198941 0.0000 −0.0057 Firmicutes; Clostridia; Clostridiales; Eubacteriaceae; Eubacterium; Eubacterium_desmolans 365047 365047 0.0000 −0.0057 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Ruminococcus; Ruminococcus_sp_5_1_39BFAA 258806.c0 New.0.CleanUp.Refer- 0.0051 −0.0056 Actinobacteria; 1760; Coriobacteriales; Coriobacteriaceae enceOTU258806 298533 298533 0.0012 −0.0055 Bacteroidetes; Bacteroidia; Bacteroidales; Prevotellaceae; Prevotella 367433 367433 0.0000 −0.0053 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Faecalibacterium; Faecalibacterium_prausnitzii 11372 11372 0.0052 −0.0053 Actinobacteria; 1760; Coriobacteriales; Coriobacteriaceae; Eggerthella; Eggerthella_lenta 189396 189396 0.0000 −0.0052 Firmicutes; Clostridia; Clostridiales; Lachnospiraceae; Coprococcus; Coprococcus_comes 24916 24916 0.0000 −0.0052 Bacteroidetes; Bacteroidia; Bacteroidales; Prevotellaceae; Prevotella 348374 348374 0.0089 −0.0052 Bacteroidetes; Bacteroidia; Bacteroidales; Bacteroidaceae; Bacteroides; Bacteroides_thetaiotaomicron 517331 517331 0.0000 −0.0052 Bacteroidetes; Bacteroidia; Bacteroidales; Prevotellaceae; Prevotella 574.d0 New.0.Refer- 0.0356 −0.0049 Actinobacteria; 1760; Coriobacteriales; Coriobacteriaceae enceOTU574 189827 189827 0.0002 −0.0049 2 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Ruminococcus; Ruminococcus_sp_5_1_39BFAA 235476.c0 New.0.CleanUp.Refer- 0.0449 −0.0049 Actinobacteria; 1760; Coriobacteriales; Coriobacteriaceae enceOTU235476 294710 294710 0.0002 −0.0048 Firmicutes; Clostridia; Clostridiales; Clostridiaceae; Clostridium 369164 369164 0.0000 −0.0047 Firmicutes; Clostridia; Clostridiales 145149 145149 0.0335 −0.0046 Firmicutes; Negativicutes; Selenomonadales; Veillonellaceae; Veillonella 369502 369502 0.0025 −0.0043 Firmicutes; Clostridia; Clostridiales; Lachnospiraceae; Coprococcus; Coprococcus_catus 199293 199293 0.0000 −0.0042 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Faecalibacterium; Faecalibacterium_prausnitzii 209122 209122 0.0001 −0.0041 Firmicutes; Clostridia; Clostridiales 184037 184037 0.0003 −0.0041 Firmicutes; Clostridia; Clostridiales; Clostridiaceae; Clostridium; Clostridium_sp_SS2_1 174902 174902 0.0021 −0.0041 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Faecalibacterium; Faecalibacterium_prausnitzii 177772 177772 0.0000 −0.0041 Firmicutes; Clostridia; Clostridiales; Eubacteriaceae; Eubacterium; Eubacterium_rectale 185281 185281 0.0000 −0.0041 Firmicutes; Clostridia; Clostridiales 305760 305760 0.0087 −0.0040 Proteobacteria; Gammaproteobacteria; Enterobacteriales; Enterobacteriaceae; Escherichia; Escherichia_coli 179460 179460 0.0001 −0.0040 Firmicutes; Clostridia; Clostridiales; Clostridiaceae; Clostridium 198161 198161 0.0001 −0.0040 Bacteroidetes; Bacteroidia; Bacteroidales 182994 182994 0.0000 −0.0039 Firmicutes; Clostridia; Clostridiales; Eubacteriaceae; Eubacterium; Eubacterium_rectale 179287 179287 0.0006 −0.0038 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Faecalibacterium; Faecalibacterium_prausnitzii 294196 294196 0.0000 −0.0037 Bacteroidetes; Bacteroidia; Bacteroidales; Prevotellaceae; Prevotella; Prevotella_copri 208539 208539 0.0002 −0.0037 Firmicutes; Clostridia; Clostridiales; Eubacteriaceae; Eubacterium 177005 177005 0.0017 −0.0037 Firmicutes; Clostridia; Clostridiales 191306 191306 0.0001 −0.0037 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Ruminococcus; Ruminococcus_sp_5_1_39BFAA 195493 195493 0.0023 −0.0037 Firmicutes; Clostridia; Clostridiales; Lachnospiraceae; Roseburia; Roseburia_intestinalis 177495 177495 0.0002 −0.0037 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Subdoligranulum; Subdoligranulum_variabile 325608 325608 0.0009 −0.0036 Firmicutes; Clostridia; Clostridiales; Clostridiaceae; Clostridium; Clostridium_bartlettii 168716 168716 0.0000 −0.0036 Firmicutes; Clostridia; Clostridiales 325969 325969 0.0110 −0.0036 Firmicutes; Clostridia; Clostridiales; Clostridiaceae; Clostridium; Clostridium_sp_SS2_1 181170 181170 0.0007 −0.0035 Firmicutes; Clostridia; Clostridiales 541301 541301 0.0035 −0.0035 Bacteroidetes; Bacteroidia; Bacteroidales; Porphyromonadaceae; Parabacteroides; Parabacteroides_merdae 340615 340615 0.0110 −0.0035 Firmicutes; Clostridia; Clostridiales; Eubacteriaceae; Eubacterium; Eubacterium_hallii 204593 204593 0.0049 −0.0035 Firmicutes; Clostridia; Clostridiales; Eubacteriaceae; Eubacterium; Eubacterium_coprostanoligenes 193067 193067 0.0000 −0.0034 Firmicutes; Clostridia; Clostridiales; Eubacteriaceae; Eubacterium; Eubacterium_rectale 181003 181003 0.0017 −0.0034 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Ruminococcus 172962 172962 0.0042 −0.0034 Bacteroidetes; Bacteroidia; Bacteroidales; Prevotellaceae; Prevotella 363400 363400 0.0108 −0.0034 Firmicutes; Clostridia; Clostridiales; Clostridiaceae; Clostridium; Clostridium_clostridioforme 171.d0 New.0.Refer- 0.0367 −0.0034 Proteobacteria enceOTU171 172274 172274 0.0042 −0.0034 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Faecalibacterium; Faecalibacterium_prausnitzii 212304 212304 0.0001 −0.0034 Firmicutes; Clostridia; Clostridiales 175682 175682 0.0000 −0.0034 Firmicutes; Clostridia; Clostridiales; Eubacteriaceae; Eubacterium; Eubacterium_rectale 361809 361809 0.0093 −0.0034 13 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Ruminococcus; Ruminococcus_torques 316732 316732 0.0022 −0.0034 Firmicutes; Clostridia; Clostridiales 111135 111135 0.0069 −0.0034 Proteobacteria; Betaproteobacteria; Burkholderiales; Sutterellaceae; Sutterella; Sutterella_wadsworthensis 528303 528303 0.0000 −0.0033 Bacteroidetes; Bacteroidia; Bacteroidales; Prevotellaceae; Prevotella 182087 182087 0.0033 −0.0032 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Faecalibacterium; Faecalibacterium_prausnitzii 210269 210269 0.0489 −0.0031 Proteobacteria; Gammaproteobacteria; Enterobacteriales; Enterobacteriaceae 188.d1 New.1.Refer- 0.0372 −0.0031 Firmicutes; Negativicutes; Selenomonadales; Veillonellaceae; Megamonas enceOTU188 71685 71685 0.0262 −0.0031 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Ruminococcus; Ruminococcus_torques 162623 162623 0.0002 −0.0031 Firmicutes; Clostridia; Clostridiales 185951 185951 0.0108 −0.0031 23 Firmicutes; Clostridia; Clostridiales 203590 203590 0.0110 −0.0030 Firmicutes; Clostridia; Clostridiales; Clostridiaceae; Clostridium 291266 291266 0.0000 −0.0030 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Subdoligranulum; Subdoligranulum_variabile 184511 184511 0.0112 −0.0030 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Faecalibacterium; Faecalibacterium_prausnitzii 188236 188236 0.0002 −0.0030 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Faecalibacterium; Faecalibacterium_prausnitzii 263461 263461 0.0223 −0.0029 Firmicutes; Clostridia; Clostridiales 181139 181139 0.0001 −0.0029 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Faecalibacterium; Faecalibacterium_prausnitzii 442.d0 New.0.Refer- 0.0051 −0.0029 Bacteroidetes enceOTU442 352304 352304 0.0035 −0.0029 Firmicutes; Clostridia; Clostridiales; Lachnospiraceae; Roseburia 178146 178146 0.0075 −0.0029 Firmicutes; Clostridia; Clostridiales; Eubacteriaceae; Eubacterium; Eubacterium_hallii 181882 181882 0.0002 −0.0029 Firmicutes; Clostridia; Clostridiales 323253 323253 0.0298 −0.0028 Unknown bacteria 207570 207570 0.0015 −0.0028 Firmicutes; Clostridia; Clostridiales; Clostridiaceae; Clostridium; Clostridium_lactatifermentans 9514 9514 0.0335 −0.0028 16 Proteobacteria; Gammaproteobacteria; Pasteurellales; Pasteurellaceae; Haemophilus; Haemophilus_parainfluenzae 174256 174256 0.0039 −0.0028 Firmicutes; Clostridia; Clostridiales; Eubacteriaceae; Eubacterium; Eubacterium_hallii 206931 206931 0.0001 −0.0028 Firmicutes; Clostridia; Clostridiales 212787 212787 0.0000 −0.0027 Firmicutes; Clostridia; Clostridiales 173135 173135 0.0018 −0.0027 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Faecalibacterium; Faecalibacterium_prausnitzii 203620 203620 0.0060 −0.0026 Firmicutes; Clostridia; Clostridiales 354737 354737 0.0017 −0.0026 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Subdoligranulum; Subdoligranulum_variabile 69909 69909 0.0107 −0.0026 Firmicutes; Clostridia; Clostridiales; Eubacteriaceae; Eubacterium; Eubacterium_ramulus 555326 555326 0.0190 −0.0026 Firmicutes; Negativicutes; Selenomonadales; Acidaminococcaceae; Phascolarctobacterium; Phascolarctobacterium_succinatutens 16054 16054 0.0092 −0.0026 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Ruminococcus; Ruminococcus_callidus 325738 325738 0.0043 −0.0025 Bacteroidetes; Bacteroidia; Bacteroidales; Bacteroidaceae; Bacteroides; Bacteroides_galacturonicus 329096 329096 0.0335 −0.0025 Proteobacteria; Gammaproteobacteria; Enterobacteriales; Enterobacteriaceae 287510 287510 0.0338 −0.0025 11 Firmicutes; Erysipelotrichi; Erysipelotrichales; Erysipelotrichaceae; Catenibacterium; Catenibacterium_mitsuokai 175537 175537 0.0001 −0.0025 Firmicutes; Clostridia; Clostridiales 187846 187846 0.0022 −0.0025 Firmicutes; Clostridia; Clostridiales; Eubacteriaceae; Eubacterium; Eubacterium_desmolans 183879 183879 0.0312 −0.0024 Firmicutes; Clostridia; Clostridiales 179795 179795 0.0017 −0.0024 Firmicutes; Clostridia; Clostridiales; Clostridiaceae; Clostridium 191547 191547 0.0013 −0.0023 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Faecalibacterium; Faecalibacterium_prausnitzii 260352 260352 0.0301 −0.0023 Firmicutes; Clostridia; Clostridiales; Eubacteriaceae; Eubacterium; Eubacterium_coprostanoligenes 329728 329728 0.0071 −0.0023 Bacteroidetes; Bacteroidia; Bacteroidales; Prevotellaceae; Prevotella 205408 205408 0.0335 −0.0023 Proteobacteria; Gammaproteobacteria; Aeromonadales; Succinivibrionaceae; Succinivibrio; Succinivibrio_dextrinosolvens 293221 293221 0.0223 −0.0022 Firmicutes; Clostridia; Clostridiales; Lachnospiraceae; Roseburia; Roseburia_intestinalis 293896 293896 0.0087 −0.0022 Firmicutes; Clostridia; Clostridiales 113909 113909 0.0007 −0.0022 Firmicutes; Clostridia; Clostridiales; Eubacteriaceae; Eubacterium; Eubacterium_rectale 338889 338889 0.0291 −0.0021 Bacteroidetes; Bacteroidia; Bacteroidales; Prevotellaceae; Prevotella 259959 259959 0.0293 −0.0021 Bacteroidetes; Bacteroidia; Bacteroidales; Prevotellaceae; Prevotella; Prevotella_sp_oral_taxon_302 193632 193632 0.0013 −0.0021 Firmicutes; Clostridia; Clostridiales; Oscillospiraceae; Oscillibacter; Oscillibacter_sp_G2 186640 186640 0.0015 −0.0020 Firmicutes; Clostridia; Clostridiales 529733 529733 0.0307 −0.0020 Bacteroidetes; Bacteroidia; Bacteroidales; Prevotellaceae; Prevotella 321016 321016 0.0135 −0.0019 Firmicutes; Clostridia; Clostridiales 16076 16076 0.0335 −0.0018 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Ruminococcus; Ruminococcus_bromii 209578 209578 0.0092 −0.0018 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Ruminococcus 215433 215433 0.0489 −0.0017 Firmicutes; Clostridia; Clostridiales 192252 192252 0.0054 −0.0017 Firmicutes; Clostridia; Clostridiales; Eubacteriaceae; Eubacterium; Eubacterium_rectale 196225.c0 New.0.CleanUp.Refer- 0.0449 −0.0016 Bacteroidetes; Bacteroidia; Bacteroidales; Prevotellaceae; Prevotella enceOTU196225 194648 194648 0.0136 −0.0015 Firmicutes; Clostridia; Clostridiales; unclassified_Clostridiales; Blautia; Blautia_sp_M25 560141 560141 0.0356 −0.0015 Actinobacteria; 1760; Coriobacteriales; Coriobacteriaceae 172603 172603 0.0219 −0.0014 Firmicutes; Clostridia; Clostridiales; Eubacteriaceae; Eubacterium; Eubacterium_hallii 187524 187524 0.0027 −0.0014 Firmicutes; Clostridia; Clostridiales 195102 195102 0.0060 −0.0013 Firmicutes; Clostridia; Clostridiales 343985 343985 0.0032 −0.0013 Firmicutes 207065 207065 0.0108 −0.0013 Firmicutes; Clostridia; Clostridiales 189047 189047 0.0177 −0.0013 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae 310301 310301 0.0075 −0.0013 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Faecalibacterium; Faecalibacterium_prausnitzii 364261 364261 0.0244 −0.0013 Firmicutes; Clostridia; Clostridiales 516022 516022 0.0276 −0.0012 Firmicutes 190572 190572 0.0018 −0.0012 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Faecalibacterium; Faecalibacterium_prausnitzii 571220 571220 0.0194 −0.0012 Firmicutes; Clostridia; Clostridiales 293360 293360 0.0414 −0.0009 Firmicutes; Clostridia; Clostridiales 298079 298079 0.0383 −0.0007 Firmicutes; Clostridia; Clostridiales 179291 179291 0.0299 −0.0007 Firmicutes; Clostridia; Clostridiales; Ruminococcaceae; Faecalibacterium; Faecalibacterium_prausnitzii 54730 54730 0.0394 −0.0007 Unknown bacteria 352215 352215 0.0298 −0.0007 Firmicutes; Clostridia; Clostridiales 43267 43267 0.0258 −0.0006 Firmicutes; Clostridia; Clostridiales 312816.c0 New.0.CleanUp.Refer- 0.0449 −0.0005 Firmicutes; Clostridia; Clostridiales; Clostridiaceae enceOTU312816

TABLE 14 Relative microbiota maturity, Microbiota-for-Age Z-score and age- adjusted Shannon Diversity Index in relation to antibiotic usage and diarrhoea during the post-intervention follow-up period Intervention Arm Estimate Std. Error p value Relative microbiota maturity Antibiotics RUTF −0.37 0.81 0.65 diarrhoea −0.92 2.03 0.65 Chronologic Age −0.18 0.12 0.13 Antibiotics Khichuri- 0.17 0.92 0.85 diarrhoea Halwa 0.31 1.57 0.84 Chronologic Age 0.11 0.13 0.41 Microbiota-for-Age Z score Antibiotics RUTF 0.15 0.31 0.64 diarrhoea 0.27 0.53 0.61 Chronologic Age −0.03 0.04 0.43 Antibiotics Khichuri- 0.07 0.25 0.77 diarrhoea Halwa −0.42 0.61 0.49 Chronologic Age −0.12 0.03 <0.001 Age-adjusted Shannon Diversity Index Antibiotics 0.02 0.22 0.91 diarrhoea RUTF 0.07 0.47 0.88 Chronologic Age −0.05 0.02 0.03 Antibiotics Khichuri- −0.32 0.19 0.09 diarrhoea Halwa −0.49 0.32 0.13 Chronologic Age 0.00 0.02 0.89 Estimates of beta coefficients, standard error and p-values from linear mixed models with random by-child intercepts and chronologic age as a fixed effect covariate for each intervention arm

TABLE 15 Metadata associated with individual fecal samples collected from 33 children in singleton cohort with and without MAM Threshold for Child ID Fecal Sample ID Gender MAM Diagnosis Age, days Age, months WHZ HAZ WAZ Bgsng7001 Bgsng7001.m19 Male MAM 552 18.1 −2.87 −2.9 −3.38 Bgsng7013 Bgsng7013.m19 Male MAM 547 18.0 −2.54 −3.16 −3.31 Bgsng7031 Bgsng7031.m19 Female MAM 557 18.3 −2.08 −2.67 −2.86 Bgsng7082 Bgsng7082.m19 Female MAM 551 18.1 −3.7 −0.83 −3.11 Bgsng7094 Bgsng7094.m19 Female MAM 562 18.5 −2.1 −2.49 −2.78 Bgsng7109 Bgsng7109.m18 Male MAM 548 18.0 −2.62 −4 −3.78 Bgsng7110 Bgsng7110.m18 Female MAM 552 18.1 −2.72 −2.07 −3 Bgsng7116 Bgsng7116.m19 Male MAM 553 18.2 −2.7 −2.41 −3.05 Bgsng7123 Bgsng7123.m18 Female MAM 548 18.0 −2.95 −2.67 −3.46 Bgsng7148 Bgsng7148.m19 Female MAM 551 18.1 −3.69 −2.32 −3.79 Bgsng7004 Bgsng7004.m19 Male Not MAM 557 18.3 −1.68 −3.63 −2.99 Bgsng7018 Bgsng7018.m19 Male Not MAM 551 18.1 −1.6 −1.29 −1.78 Bgsng7040 Bgsng7040.m19 Female Not MAM 551 18.1 −0.1 −3.01 −1.56 Bgsng7050 Bgsng7050.m19 Female Not MAM 555 18.2 −0.2 −2.54 −1.37 Bgsng7052 Bgsng7052.m19 Male Not MAM 552 18.1 −1.05 −0.87 −1.2 Bgsng7063 Bgsng7063.m19 Male Not MAM 553 18.2 −0.87 −0.85 −1.06 Bgsng7071 Bgsng7071.m19 Male Not MAM 554 18.2 −0.04 0.02 −0.07 Bgsng7074 Bgsng7074.m19 Male Not MAM 556 18.3 −1.82 −3.47 −2.99 Bgsng7081 Bgsng7081.m19 Female Not MAM 551 18.1 −0.73 −2.25 −1.62 Bgsng7087 Bgsng7087.m19 Female Not MAM 551 18.1 −1.63 −2.5 −2.43 Bgsng7090 Bgsng7090.m19 Male Not MAM 552 18.1 −0.71 −0.75 −0.9 Bgsng7096 Bgsng7096.m19 Female Not MAM 560 18.4 −0.68 −1.98 −1.44 Bgsng7108 Bgsng7108.m18 Male Not MAM 548 18.0 −1.32 −2.51 −2.14 Bgsng7130 Bgsng7130.m19 Male Not MAM 544 17.9 −1.89 −4.18 −3.43 Bgsng7131 Bgsng7131.m19 Male Not MAM 570 18.7 −1.63 −1.9 −2.07 Bgsng7133 Bgsng7133.m19 Female Not MAM 558 18.3 −1.64 −2.3 −2.33 Bgsng7135 Bgsng7135.m19 Female Not MAM 549 18.0 −0.96 −2.34 −1.84 Bgsng7145 Bgsng7145.m19 Male Not MAM 549 18.0 1.38 −4.18 −1.08 Bgsng7149 Bgsng7149.m19 Female Not MAM 565 18.6 −1.05 −0.84 −1.16 Bgsng7152 Bgsng7152.m19 Male Not MAM 554 18.2 −1.5 −1.96 −2 Bgsng7173 Bgsng7173.m19 Male Not MAM 556 18.3 0.14 −1.58 −0.63 Bgsng7178 Bgsng7178.m19 Female Not MAM 560 18.4 0.72 −0.91 0.11 Bgsng7203 Bgsng7203.m19 Male Not MAM 551 18.1 0.16 −3.44 −1.55 Diet at time of fecal Antibiotics Number of sample collection diarrhoea at the within 7 days high quality 16S rRNA Breast Solid time of sample prior to sample Medications V4-16S rRNA Sequencing Child ID Milk Foods Formula collection collection (Antibiotics and other) sequences Run ID Bgsng7001 Yes Yes No No No Chlorpheniramine 18,860 7 Maleate, Paracetamol Bgsng7013 Yes Yes No Yes No 18,634 7 Bgsng7031 Yes Yes No No No 15,771 7 Bgsng7082 Yes Yes No No No 46,439 4 Bgsng7094 Yes Yes No No No 21,799 5 Bgsng7109 Yes Yes No No No 25,516 6 Bgsng7110 Yes Yes No No No 21,546 6 Bgsng7116 Yes Yes No No Yes Flucloxacillin Sodium, 20,166 5 Chlorpheniramine Maleate, Multi Vitamin Bgsng7123 Yes Yes No No No 27,214 7 Bgsng7148 Yes Yes No No No 44,754 4 Bgsng7004 Yes Yes No No No 23,688 4 Bgsng7018 Yes Yes No No Yes Flucloxacillin Sodium 25,765 7 Bgsng7040 Yes Yes No No No 49,576 7 Bgsng7050 Yes Yes No No No Chlorpheniramine 13,988 5 Maleate, Multi Vitamin Bgsng7052 Yes Yes No No No 25,364 5 Bgsng7063 Yes Yes No No No 23,878 7 Bgsng7071 Yes Yes No No No Paracetamol 21,695 5 Bgsng7074 Yes Yes No Yes No Oral rehydration 15,006 5 saline, Multi Vitamin Bgsng7081 Yes Yes No No No 17,264 5 Bgsng7087 Yes Yes No No No 19,084 5 Bgsng7090 Yes Yes No No Yes Amoxycillin trihydrate, 20,562 5 Sulbutamol Bgsng7096 Yes Yes No No No 27,208 5 Bgsng7108 Yes Yes No No No 21,247 6 Bgsng7130 Yes Yes No No No 26,268 5 Bgsng7131 Yes Yes No No No 39,288 5 Bgsng7133 Yes Yes No Yes Yes Azithromycin 23,886 5 Dihydrate, Oral rehydration saline, Chlorpheniramine Maleate Bgsng7135 Yes Yes No No No 18,644 5 Bgsng7145 Yes Yes No No No 24,350 4 Bgsng7149 Yes Yes No No No 21,384 4 Bgsng7152 Yes Yes No No No 22,772 4 Bgsng7173 Yes Yes No No Yes Amoxicillin trihydrate + 22,652 9 Clavulanic acid, Chloramphenicol, Sulbutamol Bgsng7178 Yes Yes No No No 26,494 9 Bgsng7203 Yes Yes No No No 15,174 7

TABLE 16 Metadata associated with individual fecal samples from concordant healthy Malawian twins and triplets Number of high quality 16S rRNA V4-16S rRNA Sequencing Family ID Child ID Gender Zygosity Fecal Sample ID Age, months WHZ sequences Run ID h208 h208A female MZ h208A.1 0.4 −1.73 133,515 Malawi89 h301 h301A male DZ h301A.1 0.6 0.2 101,465 Malawi89 h301 h301B male DZ h301B.1 0.6 −0.33 135,737 Malawi89 h257 h257A male MZ h257A.1 2.3 −0.62 117,949 Malawi89 h257 h257B male MZ h257B.1 2.3 0.47 121,595 Malawi89 h181 h181A male DZ h181A.1 2.6 0.36 221,464 Malawi7 h181 h181B male MZ h181B.1 2.6 −0.25 229,814 Malawi7 h181 h181C male MZ h181C.1 2.6 −0.99 216,056 Malawi7 h259 h259A female MZ h259A.2 3.2 1.86 197,189 Malawi7 h259 h259B female MZ h259B.2 3.2 1.53 200,122 Malawi7 h305 h305B male DZ h305B.2 4.7 −1 131,898 Malawi89 h305 h305C female DZ h305C.2 4.7 −0.42 111,403 Malawi89 h121 h121B male MZ h121B.1 5.2 2.58 122,051 Malawi89 h165 h165A male MZ h165A.1 5.3 −0.58 230,639 Malawi7 h165 h165B male MZ h165B.1 5.3 −0.38 236,422 Malawi7 h209 h209A female MZ h209A.2 6.8 −0.18 101,469 Malawi89 h209 h209B female MZ h209B.2 6.8 −0.83 80,917 Malawi89 h47 h47A male MZ h47A.1 7.2 −0.93 64,752 Malawi6 h47 h47B male MZ h47B.1 7.2 −2.26 99,204 Malawi7 h235 h235A male MZ h235A.1 8.0 −1.09 118,988 Malawi89 h235 h235B male MZ h235B.1 8.0 −0.31 108,240 Malawi89 h128 h128A male MZ h128A.1 9.1 −1.31 177,426 Malawi7 h264 h264A female MZ h264A.2 9.6 0.01 122,455 Malawi89 h264 h264B female MZ h264B.2 9.6 −0.33 246,575 Malawi7 h273 h273A female MZ h273A.2 11.1 0.48 245,101 Malawi7 h273 h273B female MZ h273B.2 11.1 0.81 245,319 Malawi7 h37 h37A female DZ h37A.2 11.2 −1.07 141,448 Malawi89 h37 h37B female DZ h37B.2 11.2 −0.27 142,827 Malawi89 h279 h279A male MZ h279A.2 11.4 0.96 106,307 Malawi89 h279 h279B male MZ h279B.2 11.4 −1.01 110,396 Malawi89 h144 h144A male MZ h144A.1 14.6 −0.74 230,465 Malawi7 h144 h144B male MZ h144B.1 14.6 −1.96 289,895 Malawi7 h10 h10A female DZ h10A.2 16.1 −0.32 130,876 Malawi89 h18 h18A female MZ h18A.4 16.2 0.51 76,375 Malawi6 h18 h18B female MZ h18B.4 16.2 0.08 70,390 Malawi6 h68 h68A male DZ h68A.4 20.4 −0.09 267,547 Malawi3 h68 h68B male DZ h68B.4 20.4 0 70,403 Malawi3 h35 h35A male MZ h35A.3 22.7 −2.16 46,022 Malawi6 h78 h78A male DZ h78A.4 22.7 −0.7 241,999 Malawi3 h78 h78B male DZ h78B.4 22.7 0.95 216,988 Malawi3 h186 h186A male MZ h186A.1 24.2 0.09 120,553 Malawi89 h186 h186B female DZ h186B.1 24.2 1.36 62,791 Malawi7 h186 h186C male MZ h186C.1 24.2 −0.07 121,883 Malawi89 h60 h60A female MZ h60A.2 24.5 0.04 232,045 Malawi7 h60 h60B female MZ h60B.2 24.5 −0.29 93,313 Malawi89 h101 h101A female MZ h101A.3 25.1 −0.55 111,821 Malawi89 h101 h101B female MZ h101B.3 25.1 −0.16 122,049 Malawi89

TABLE 17 Results of clinical microscopy of fecal samples obtained from healthy Bangladeshi children and those with MAM Enteropathogens detected Fecal Sample ID Study Group Giardia lamblia Ascaris lumbricoides Trichuris Tricuria The following enteropathogens were not detected in any sample: Entamoeba histolytica/Entamoeba dispar, Escherichia coli, Endolimax nana, Iodamoeba butschlii, Chilomastix mesnili, Blastocystis hominia, Coccidian-like body (CLB), Ancylostoma duodenale/Necator americanus, or Hymenolepsis nana Bgsng7035.m23 Healthy Singleton Birth Cohort − + − Bgsng7106.m12 Healthy Singleton Birth Cohort + − − Bgsng7106.m16 Healthy Singleton Birth Cohort + − − Bgsng7106.m24 Healthy Singleton Birth Cohort + − − Bgsng7128.m11 Healthy Singleton Birth Cohort + − − Bgsng7128.m12 Healthy Singleton Birth Cohort + − − Bgsng7128.m18 Healthy Singleton Birth Cohort + + − Bgsng7128.m19 Healthy Singleton Birth Cohort − + − Bgsng7177.m19 Healthy Singleton Birth Cohort + − − Bgsng7177.m20 Healthy Singleton Birth Cohort + − − Bgsng7192.m19 Healthy Singleton Birth Cohort + − − Bgsng7204.m17 Healthy Singleton Birth Cohort − + − Bgsng7204.m19 Healthy Singleton Birth Cohort − + − Bgsng7204.m20 Healthy Singleton Birth Cohort − + − Bgsng7204.m22 Healthy Singleton Birth Cohort − + − Bgsng7204.m23 Healthy Singleton Birth Cohort − + − Bgsng8169.m17 Healthy Singleton Birth Cohort − + − Bgsng8169.m18 Healthy Singleton Birth Cohort − + − Bgsng8169.m19 Healthy Singleton Birth Cohort − + − Bgsng8169.m22 Healthy Singleton Birth Cohort − + − Bgsng8169.m23 Healthy Singleton Birth Cohort − + − Bgsng8169.m24 Healthy Singleton Birth Cohort − + − Bgsng7052.m15 Healthy Singleton Birth Cohort + − − Bgsng7052.m17 Healthy Singleton Birth Cohort + − − Bgsng7052.m24 Healthy Singleton Birth Cohort + − − Bgsng7071.m18 Healthy Singleton Birth Cohort − + − Bgsng7082.m17 Healthy Singleton Birth Cohort − + − Bgsng7096.m9 Healthy Singleton Birth Cohort + − − Bgsng7096.m13 Healthy Singleton Birth Cohort + − − Bgsng7096.m16 Healthy Singleton Birth Cohort + − − Bgsng7096.m19 Healthy Singleton Birth Cohort + − − Bgsng7096.m21 Healthy Singleton Birth Cohort + − − Bgsng7096.m22 Healthy Singleton Birth Cohort + − − Bgsng7096.m24 Healthy Singleton Birth Cohort + − − Bgsng7142.m18 Healthy Singleton Birth Cohort + − − Bgsng7142.m20 Healthy Singleton Birth Cohort + − − Bgsng7142.m24 Healthy Singleton Birth Cohort + − − Bgsng7149.m14 Healthy Singleton Birth Cohort − + − Bgsng7149.m15 Healthy Singleton Birth Cohort − + − Bgsng7149.m16 Healthy Singleton Birth Cohort − + − Bgsng7149.m18 Healthy Singleton Birth Cohort − + − Bgsng7149.m19 Healthy Singleton Birth Cohort − + − Bgsng7149.m21 Healthy Singleton Birth Cohort − + + Bgsng7149.m24 Healthy Singleton Birth Cohort − + − Bgsng7173.m12 Healthy Singleton Birth Cohort − + − Bgsng7173.m22 Healthy Singleton Birth Cohort − + − Bgsng7173.m24 Healthy Singleton Birth Cohort + − − Bgsng7178.m14 Healthy Singleton Birth Cohort − + − Bgsng7178.m18 Healthy Singleton Birth Cohort − + − Bgsng7178.m23 Healthy Singleton Birth Cohort − + − Bgtw1.T1.m18 Healthy Twins & Triplets − + − Bgtw2.T1.m21 Healthy Twins & Triplets − + − Bgtw2.T1.m22 Healthy Twins & Triplets − + − Bgtw5.T1.m3 Healthy Twins & Triplets + − − Bgtw11.T1.m1 Healthy Twins & Triplets − + − Bgtw1.T2.m21 Healthy Twins & Triplets − + − Bgtw2.T2.m21 Healthy Twins & Triplets − + − Bgtw5.T2.m3 Healthy Twins & Triplets − − + Bgtw8.T2.m7 Healthy Twins & Triplets − + + Bgsng7013.m19 Additional singletons sampled with and + − − without MAM at 18 months Bgsng7040.m19 Additional singletons sampled with and − + − without MAM at 18 months Bgsng7148.m19 Additional singletons sampled with and − + − without MAM at 18 months Samples for which the enteropathogens tested for were not detected: Bgsng7035.m1 Bgsng7202.m21 Bgsng7096.m15 Bgtw4.T1.m5 Bgtw4.T2.m4 Bgsng7035.m2 Bgsng7202.m22 Bgsng7096.m17 Bgtw4.T1.m6 Bgtw4.T2.m5 Bgsng7035.m3 Bgsng7202.m23 Bgsng7096.m20 Bgtw4.T1.m7 Bgtw4.T2.m6 Bgsng7035.m4 Bgsng7202.m24 Bgsng7096.m23 Bgtw4.T1.m8 Bgtw4.T2.m8 Bgsng7035.m5 Bgsng7204.m1 Bgsng7114.m1 Bgtw4.T1.m9 Bgtw4.T2.m9 Bgsng7035.m6 Bgsng7204.m2 Bgsng7114.m2 Bgtw4.T1.m10 Bgtw4.T2.m10 Bgsng7035.m7 Bgsng7204.m3 Bgsng7114.m3 Bgtw4.T1.m11 Bgtw4.T2.m11 Bgsng7035.m8 Bgsng7204.m4 Bgsng7114.m4 Bgtw4.T1.m12 Bgtw4.T2.m12 Bgsng7035.m9 Bgsng7204.m5 Bgsng7114.m5 Bgtw4.T1.m13 Bgtw4.T2.m13 Bgsng7035.m10 Bgsng7204.m6 Bgsng7114.m6 Bgtw4.T1.m14 Bgtw4.T2.m14 Bgsng7035.m11 Bgsng7204.m7 Bgsng7114.m7 Bgtw4.T1.m15 Bgtw4.T2.m15 Bgsng7035.m12 Bgsng7204.m8 Bgsng7114.m8 Bgtw4.T1.m16 Bgtw4.T2.m15.dr Bgsng7035.m13 Bgsng7204.m9 Bgsng7114.m10 Bgtw4.T1.m18 Bgtw4.T2.m17 Bgsng7035.m14 Bgsng7204.m10 Bgsng7114.m11 Bgtw4.T1.m18.drb Bgtw4.T2.m18 Bgsng7035.m15 Bgsng7204.m11 Bgsng7114.m12 Bgtw4.T1.m18.drc Bgtw4.T2.m19 Bgsng7035.m16 Bgsng7204.m12 Bgsng7114.m13 Bgtw4.T1.m20 Bgtw5.T2.m1 Bgsng7035.m17 Bgsng7204.m13 Bgsng7114.m16 Bgtw5.T1.m2 Bgtw5.T2.m2 Bgsng7035.m19 Bgsng7204.m14 Bgsng7114.m17 Bgtw5.T1.m4 Bgtw5.T2.m4 Bgsng7035.m20 Bgsng7204.m15 Bgsng7114.m18 Bgtw5.T1.m5 Bgtw5.T2.m5 Bgsng7035.m21 Bgsng7204.m16 Bgsng7114.m20 Bgtw5.T1.m6 Bgtw5.T2.m6 Bgsng7035.m22 Bgsng7204.m18 Bgsng7114.m22 Bgtw5.T1.m7 Bgtw5.T2.m8 Bgsng7035.m24 Bgsng7204.m21 Bgsng7114.m24 Bgtw5.T1.m8 Bgtw5.T2.m9 Bgsng7106.m1 Bgsng7204.m24 Bgsng7131.m1 Bgtw5.T1.m9 Bgtw5.T2.m10 Bgsng7106.m2 Bgsng8064.m1 Bgsng7131.m2 Bgtw5.T1.m10 Bgtw5.T2.m11 Bgsng7106.m3 Bgsng8064.m2 Bgsng7131.m3 Bgtw5.T1.m11 Bgtw5.T2.m12 Bgsng7106.m4 Bgsng8064.m3 Bgsng7131.m4 Bgtw5.T1.m12 Bgtw5.T2.m13 Bgsng7106.m5 Bgsng8064.m4 Bgsng7131.m5 Bgtw5.T1.m13 Bgtw5.T2.m14 Bgsng7106.m6 Bgsng8064.m5 Bgsng7131.m6 Bgtw5.T1.m14 Bgtw5.T2.m15 Bgsng7106.m9 Bgsng8064.m6 Bgsng7131.m7 Bgtw5.T1.m15 Bgtw5.T2.m16 Bgsng7106.m10 Bgsng8064.m7 Bgsng7131.m8 Bgtw5.T1.m16 Bgtw5.T2.m17 Bgsng7106.m11 Bgsng8064.m8 Bgsng7131.m9 Bgtw5.T1.m17 Bgtw5.T2.m18 Bgsng7106.m14 Bgsng8064.m9 Bgsng7131.m10 Bgtw5.T1.m18 Bgtw5.T2.m19 Bgsng7106.m18 Bgsng8064.m10 Bgsng7131.m11 Bgtw5.T1.m19 Bgtw5.T2.m20 Bgsng7106.m19 Bgsng8064.m11 Bgsng7131.m12 Bgtw5.T1.m20 Bgtw5.T2.m21 Bgsng7106.m20 Bgsng8064.m12 Bgsng7131.m13 Bgtw5.T1.m21 Bgtw5.T2.m22 Bgsng7106.m21 Bgsng8064.m13 Bgsng7131.m15 Bgtw5.T1.m22 Bgtw6.T2.m1 Bgsng7106.m22 Bgsng8064.m14 Bgsng7131.m16 Bgtw6.T1.m1 Bgtw6.T2.m2 Bgsng7106.m23 Bgsng8064.m15 Bgsng7131.m17 Bgtw6.T1.m2 Bgtw6.T2.m3 Bgsng7115.m1 Bgsng8064.m16 Bgsng7131.m18 Bgtw6.T1.m3 Bgtw6.T2.m4 Bgsng7115.m2 Bgsng8064.m17 Bgsng7131.m19 Bgtw6.T1.m4 Bgtw6.T2.m6 Bgsng7115.m3 Bgsng8064.m18 Bgsng7131.m20 Bgtw6.T1.m7 Bgtw6.T2.m7 Bgsng7115.m4 Bgsng8064.m19 Bgsng7131.m21 Bgtw6.T1.m8 Bgtw6.T2.m8 Bgsng7115.m5 Bgsng8064.m20 Bgsng7131.m22 Bgtw6.T1.m9 Bgtw6.T2.m9 Bgsng7115.m6 Bgsng8064.m21 Bgsng7131.m23 Bgtw6.T1.m10 Bgtw6.T2.m10 Bgsng7115.m7 Bgsng8064.m22 Bgsng7131.m24 Bgtw7.T1.m1 Bgtw6.T2.m15.dr Bgsng7115.m8 Bgsng8064.m23 Bgsng7142.m1 Bgtw7.T1.m2 Bgtw7.T2.m1 Bgsng7115.m9 Bgsng8064.m24 Bgsng7142.m2 Bgtw7.T1.m3 Bgtw7.T2.m2 Bgsng7115.m10 Bgsng8169.m1 Bgsng7142.m3 Bgtw7.T1.m4 Bgtw7.T2.m3 Bgsng7115.m11 Bgsng8169.m3 Bgsng7142.m4 Bgtw7.T1.m5 Bgtw7.T2.m4 Bgsng7115.m12 Bgsng8169.m5 Bgsng7142.m5 Bgtw7.T1.m6 Bgtw7.T2.m5 Bgsng7115.m13 Bgsng8169.m6 Bgsng7142.m6 Bgtw7.T1.m6.dra Bgtw7.T2.m6 Bgsng7115.m14 Bgsng8169.m7 Bgsng7142.m7 Bgtw7.T1.m6.drb Bgtw7.T2.m6.dra Bgsng7115.m15 Bgsng8169.m8 Bgsng7142.m8 Bgtw7.T1.m7 Bgtw7.T2.m6.drb Bgsng7115.m16 Bgsng8169.m9 Bgsng7142.m9 Bgtw7.T1.m8 Bgtw7.T2.m8 Bgsng7115.m17 Bgsng8169.m10 Bgsng7142.m11 Bgtw7.T1.m9 Bgtw7.T2.m9 Bgsng7115.m18 Bgsng8169.m11 Bgsng7142.m12 Bgtw7.T1.m10 Bgtw7.T2.m10 Bgsng7115.m20 Bgsng8169.m12 Bgsng7142.m13 Bgtw7.T1.m11 Bgtw7.T2.m11 Bgsng7115.m23 Bgsng8169.m13 Bgsng7142.m14 Bgtw7.T1.m12 Bgtw7.T2.m12 Bgsng7115.m24 Bgsng8169.m14 Bgsng7142.m15 Bgtw7.T1.m13 Bgtw7.T2.m13 Bgsng7128.m1 Bgsng8169.m15 Bgsng7142.m16 Bgtw7.T1.m14 Bgtw7.T2.m14 Bgsng7128.m2 Bgsng8169.m16 Bgsng7142.m17 Bgtw7.T1.m15 Bgtw7.T2.m15 Bgsng7128.m3 Bgsng8169.m20 Bgsng7142.m21 Bgtw7.T1.m16 Bgtw7.T2.m16 Bgsng7128.m4 Bgsng8169.m21 Bgsng7142.m22 Bgtw8.T1.m1 Bgtw8.T2.m1 Bgsng7128.m5 Bgsng7018.m1 Bgsng7142.m23 Bgtw8.T1.m2 Bgtw8.T2.m2 Bgsng7128.m6 Bgsng7018.m2 Bgsng7149.m1 Bgtw8.T1.m3 Bgtw8.T2.m3 Bgsng7128.m7 Bgsng7018.m3 Bgsng7149.m2 Bgtw8.T1.m4 Bgtw8.T2.m4 Bgsng7128.m8 Bgsng7018.m4 Bgsng7149.m3 Bgtw8.T1.m5 Bgtw8.T2.m5 Bgsng7128.m9 Bgsng7018.m5 Bgsng7149.m4 Bgtw8.T1.m6 Bgtw8.T2.m6 Bgsng7128.m10 Bgsng7018.m6 Bgsng7149.m5 Bgtw8.T1.m7 Bgtw8.T2.m8 Bgsng7128.m13 Bgsng7018.m7 Bgsng7149.m6 Bgtw8.T1.m8 Bgtw8.T2.m9 Bgsng7128.m14 Bgsng7018.m8 Bgsng7149.m7 Bgtw8.T1.m9 Bgtw8.T2.m10 Bgsng7128.m16 Bgsng7018.m9 Bgsng7149.m8 Bgtw8.T1.m10 Bgtw8.T2.m11 Bgsng7128.m17 Bgsng7018.m10 Bgsng7149.m9 Bgtw8.T1.m11 Bgtw8.T2.m12 Bgsng7128.m20 Bgsng7018.m11 Bgsng7149.m10 Bgtw8.T1.m12 Bgtw8.T2.m13 Bgsng7128.m21 Bgsng7018.m12 Bgsng7149.m11 Bgtw8.T1.m13 Bgtw9.T2.m1 Bgsng7128.m22 Bgsng7018.m13 Bgsng7149.m12 Bgtw9.T1.m2 Bgtw9.T2.m2 Bgsng7128.m23 Bgsng7018.m14 Bgsng7149.m13 Bgtw9.T1.m3 Bgtw9.T2.m3 Bgsng7128.m24 Bgsng7018.m15 Bgsng7149.m17 Bgtw9.T1.m4 Bgtw9.T2.m4 Bgsng7150.m1 Bgsng7018.m16 Bgsng7149.m23 Bgtw9.T1.m5 Bgtw9.T2.m5 Bgsng7150.m2 Bgsng7018.m17 Bgsng7173.m1 Bgtw9.T1.m6 Bgtw9.T2.m6 Bgsng7150.m3 Bgsng7018.m18 Bgsng7173.m2 Bgtw9.T1.m8 Bgtw9.T2.m8 Bgsng7150.m4 Bgsng7018.m19 Bgsng7173.m3 Bgtw9.T1.m9 Bgtw9.T2.m9 Bgsng7150.m5 Bgsng7018.m20 Bgsng7173.m4 Bgtw9.T1.m10 Bgtw9.T2.m10 Bgsng7150.m6 Bgsng7018.m24 Bgsng7173.m5 Bgtw9.T1.m11 Bgtw9.T2.m11 Bgsng7150.m7 Bgsng7052.m1 Bgsng7173.m6 Bgtw9.T1.m12 Bgtw9.T2.m12 Bgsng7150.m8 Bgsng7052.m2 Bgsng7173.m7 Bgtw9.T1.m13 Bgtw9.T2.m13 Bgsng7150.m9 Bgsng7052.m3 Bgsng7173.m8 Bgtw10.T1.m1 Bgtw10.T2.m1 Bgsng7150.m10 Bgsng7052.m4 Bgsng7173.m9 Bgtw10.T1.m2 Bgtw10.T2.m2 Bgsng7150.m11 Bgsng7052.m5 Bgsng7173.m10 Bgtw10.T1.m4 Bgtw10.T2.m4 Bgsng7150.m12 Bgsng7052.m6 Bgsng7173.m11 Bgtw10.T1.m5 Bgtw10.T2.m5 Bgsng7150.m13 Bgsng7052.m7 Bgsng7173.m13 Bgtw10.T1.m6 Bgtw10.T2.m6 Bgsng7150.m14 Bgsng7052.m8 Bgsng7173.m14 Bgtw10.T1.m8 Bgtw10.T2.m7 Bgsng7150.m15 Bgsng7052.m9 Bgsng7173.m15 Bgtw10.T1.m9 Bgtw10.T2.m8 Bgsng7150.m16 Bgsng7052.m10 Bgsng7173.m16 Bgtw10.T1.m10 Bgtw10.T2.m9 Bgsng7150.m17 Bgsng7052.m11 Bgsng7173.m17 Bgtw10.T1.m11 Bgtw10.T2.m10 Bgsng7150.m18 Bgsng7052.m12 Bgsng7173.m18 Bgtw10.T1.m12 Bgtw10.T2.m11 Bgsng7150.m19 Bgsng7052.m14 Bgsng7173.m19 Bgtw10.T1.m13 Bgtw10.T2.m12 Bgsng7150.m20 Bgsng7052.m16 Bgsng7173.m20 Bgtw11.T1.m2 Bgtw10.T2.m13 Bgsng7150.m21 Bgsng7052.m18 Bgsng7173.m21 Bgtw11.T1.m3 Bgtw11.T2.m1 Bgsng7150.m24 Bgsng7052.m19 Bgsng7173.m23 Bgtw11.T1.m4 Bgtw11.T2.m2 Bgsng7155.m1 Bgsng7052.m20 Bgsng7178.m1 Bgtw11.T1.m5 Bgtw11.T2.m3 Bgsng7155.m2 Bgsng7063.m1 Bgsng7178.m2 Bgtw11.T1.m6 Bgtw11.T2.m4 Bgsng7155.m3 Bgsng7063.m2 Bgsng7178.m3 Bgtw11.T1.m7 Bgtw11.T2.m5 Bgsng7155.m4 Bgsng7063.m3 Bgsng7178.m4 Bgtw11.T1.m8 Bgtw11.T2.m6 Bgsng7155.m5 Bgsng7063.m4 Bgsng7178.m5 Bgtw11.T1.m9 Bgtw11.T2.m6.dr Bgsng7155.m6 Bgsng7063.m5 Bgsng7178.m6 Bgtw11.T1.m10 Bgtw11.T2.m7 Bgsng7155.m7 Bgsng7063.m6 Bgsng7178.m7 Bgtw11.T1.m11 Bgtw11.T2.m8 Bgsng7155.m8 Bgsng7063.m7 Bgsng7178.m8 Bgtw11.T1.m12 Bgtw11.T2.m9 Bgsng7155.m9 Bgsng7063.m8 Bgsng7178.m9 Bgtw12.T1.m1 Bgtw11.T2.m10 Bgsng7155.m10 Bgsng7063.m10 Bgsng7178.m10 Bgtw12.T1.m2 Bgtw11.T2.m12 Bgsng7155.m11 Bgsng7063.m11 Bgsng7178.m11 Bgtw12.T1.m3 Bgtw11.T2.m12.dr Bgsng7155.m12 Bgsng7063.m12 Bgsng7178.m12 Bgtw12.T1.m4 Bgtw12.T2.m1 Bgsng7155.m13 Bgsng7063.m15 Bgsng7178.m13 Bgtw12.T1.m5 Bgtw12.T2.m2 Bgsng7155.m14 Bgsng7063.m16 Bgsng7178.m15 Bgtw12.T1.m6 Bgtw12.T2.m3 Bgsng7155.m15 Bgsng7063.m17 Bgsng7178.m16 Bgtw12.T1.m7 Bgtw12.T2.m4 Bgsng7155.m16 Bgsng7063.m18 Bgsng7178.m17 Bgtw12.T1.m8 Bgtw12.T2.m5 Bgsng7155.m17 Bgsng7063.m19 Bgsng7178.m19 Bgtw12.T1.m9 Bgtw12.T2.m6 Bgsng7155.m18 Bgsng7063.m20 Bgsng7178.m20 Bgtw12.T1.m10 Bgtw12.T2.m7 Bgsng7155.m19 Bgsng7063.m21 Bgsng7178.m21 Bgtw12.T1.m11 Bgtw12.T2.m8 Bgsng7155.m20 Bgsng7063.m22 Bgsng7178.m22 Bgtw12.T1.m12 Bgtw12.T2.m9 Bgsng7155.m21 Bgsng7063.m24 Bgsng7178.m24 Bgtw12.T1.m13 Bgtw12.T2.m10 Bgsng7155.m22 Bgsng7071.m1 Bgtw1.T1.m2 Bgtw1.T2.m2 Bgtw12.T2.m11 Bgsng7155.m23 Bgsng7071.m2 Bgtw1.T1.m3 Bgtw1.T2.m3 Bgtw12.T2.m12 Bgsng7155.m24 Bgsng7071.m4 Bgtw1.T1.m4 Bgtw1.T2.m4 Bgtw12.T2.m13 Bgsng7177.m1 Bgsng7071.m5 Bgtw1.T1.m5 Bgtw1.T2.m5 Bgtw4.T3.m1 Bgsng7177.m2 Bgsng7071.m6 Bgtw1.T1.m6 Bgtw1.T2.m6 Bgtw4.T3.m2 Bgsng7177.m3 Bgsng7071.m7 Bgtw1.T1.m6.dr Bgtw1.T2.m7 Bgtw4.T3.m3 Bgsng7177.m4 Bgsng7071.m9 Bgtw1.T1.m7 Bgtw1.T2.m8 Bgtw4.T3.m4 Bgsng7177.m5 Bgsng7071.m10 Bgtw1.T1.m8 Bgtw1.T2.m9 Bgtw4.T3.m5 Bgsng7177.m6 Bgsng7071.m12 Bgtw1.T1.m9 Bgtw1.T2.m10 Bgtw4.T3.m6 Bgsng7177.m7 Bgsng7071.m14 Bgtw1.T1.m10 Bgtw1.T2.m11 Bgtw4.T3.m8 Bgsng7177.m8 Bgsng7071.m15 Bgtw1.T1.m11 Bgtw1.T2.m12 Bgtw4.T3.m8.dr Bgsng7177.m9 Bgsng7071.m16 Bgtw1.T1.m12 Bgtw1.T2.m13 Bgtw4.T3.m9 Bgsng7177.m11 Bgsng7071.m19 Bgtw1.T1.m13 Bgtw1.T2.m14 Bgtw4.T3.m10 Bgsng7177.m12 Bgsng7071.m20 Bgtw1.T1.m14 Bgtw1.T2.m15 Bgtw4.T3.m11 Bgsng7177.m13 Bgsng7071.m22 Bgtw1.T1.m15 Bgtw1.T2.m16 Bgtw4.T3.m12 Bgsng7177.m14 Bgsng7071.m23 Bgtw1.T1.m16 Bgtw1.T2.m18 Bgtw4.T3.m13 Bgsng7177.m15 Bgsng7071.m24 Bgtw1.T1.m19 Bgtw1.T2.m19 Bgtw4.T3.m14 Bgsng7177.m16 Bgsng7082.m1 Bgtw1.T1.m20 Bgtw1.T2.m22 Bgtw4.T3.m15 Bgsng7177.m17 Bgsng7082.m2 Bgtw1.T1.m21 Bgtw1.T2.m23 Bgtw4.T3.m16 Bgsng7177.m18 Bgsng7082.m3 Bgtw1.T1.m22 Bgtw1.T2.m24 Bgtw4.T3.m17 Bgsng7177.m21 Bgsng7082.m4 Bgtw1.T1.m23 Bgtw1.T2.m25 Bgtw4.T3.m18 Bgsng7177.m22 Bgsng7082.m5 Bgtw1.T1.m24 Bgtw2.T2.m2 Bgtw4.T3.m19 Bgsng7177.m23 Bgsng7082.m6 Bgtw1.T1.m24.dr Bgtw2.T2.m2.dr Bgtw4.T3.m20 Bgsng7177.m24 Bgsng7082.m7 Bgtw1.T1.m25 Bgtw2.T2.m3 Bgtw1.T1.m17 Bgsng7192.m1 Bgsng7082.m8 Bgtw2.T1.m2 Bgtw2.T2.m4 Bgtw2.T1.m6.dr Bgsng7192.m2 Bgsng7082.m9 Bgtw2.T1.m2.dr Bgtw2.T2.m5 Bgtw3.T1.m4.dr Bgsng7192.m3 Bgsng7082.m10 Bgtw2.T1.m3 Bgtw2.T2.m6 Bgtw3.T1.m5.dr Bgsng7192.m4 Bgsng7082.m11 Bgtw2.T1.m4 Bgtw2.T2.m7 Bgtw3.T1.m9.dr Bgsng7192.m5 Bgsng7082.m12 Bgtw2.T1.m5 Bgtw2.T2.m8 Bgtw3.T1.m10 Bgsng7192.m6 Bgsng7082.m15 Bgtw2.T1.m6 Bgtw2.T2.m9 Bgtw3.T1.m18.dr Bgsng7192.m7 Bgsng7082.m18 Bgtw2.T1.m7 Bgtw2.T2.m10 Bgtw4.T1.m18.dra Bgsng7192.m8 Bgsng7082.m19 Bgtw2.T1.m8 Bgtw2.T2.m11 Bgtw6.T1.m8.dr Bgsng7192.m9 Bgsng7082.m20 Bgtw2.T1.m9 Bgtw2.T2.m12 Bgtw8.T1.m5.dr Bgsng7192.m10 Bgsng7082.m24 Bgtw2.T1.m10 Bgtw2.T2.m13 Bgtw9.T1.m7 Bgsng7192.m11 Bgsng7090.m1 Bgtw2.T1.m11 Bgtw2.T2.m14 Bgtw10.T1.m2.dr Bgsng7192.m12 Bgsng7090.m2 Bgtw2.T1.m12 Bgtw2.T2.m15 Bgtw10.T1.m3 Bgsng7192.m13 Bgsng7090.m3 Bgtw2.T1.m13 Bgtw2.T2.m16 Bgtw10.T1.m4.dra Bgsng7192.m14 Bgsng7090.m4 Bgtw2.T1.m14 Bgtw2.T2.m17 Bgtw10.T1.m4.drb Bgsng7192.m15 Bgsng7090.m5 Bgtw2.T1.m15 Bgtw2.T2.m18 Bgtw10.T1.m7 Bgsng7192.m16 Bgsng7090.m6 Bgtw2.T1.m16 Bgtw2.T2.m19 Bgtw10.T1.m8.dr Bgsng7192.m17 Bgsng7090.m7 Bgtw2.T1.m17 Bgtw2.T2.m20 Bgtw12.T1.m9.dr Bgsng7192.m18 Bgsng7090.m8 Bgtw2.T1.m18 Bgtw2.T2.m22 Bgtw1.T2.m16.dr Bgsng7192.m20 Bgsng7090.m9 Bgtw2.T1.m19 Bgtw2.T2.m23 Bgtw1.T2.m17 Bgsng7192.m21 Bgsng7090.m10 Bgtw2.T1.m20 Bgtw2.T2.m24 Bgtw2.T2.m6.dr Bgsng7192.m22 Bgsng7090.m11 Bgtw2.T1.m23 Bgtw3.T2.m1 Bgtw3.T2.m4.dr Bgsng7192.m23 Bgsng7090.m12 Bgtw2.T1.m24 Bgtw3.T2.m2 Bgtw3.T2.m5.dra Bgsng7192.m24 Bgsng7090.m13 Bgtw3.T1.m1 Bgtw3.T2.m3 Bgtw3.T2.m5.drb Bgsng7202.m1 Bgsng7090.m14 Bgtw3.T1.m3 Bgtw3.T2.m4 Bgtw3.T2.m11.dr Bgsng7202.m2 Bgsng7090.m15 Bgtw3.T1.m4 Bgtw3.T2.m5 Bgtw4.T2.m19.dr Bgsng7202.m3 Bgsng7090.m16 Bgtw3.T1.m5 Bgtw3.T2.m6 Bgtw7.T2.m12.dr Bgsng7202.m4 Bgsng7090.m17 Bgtw3.T1.m6 Bgtw3.T2.m7 Bgtw9.T2.m2.dr Bgsng7202.m5 Bgsng7090.m18 Bgtw3.T1.m7 Bgtw3.T2.m8 Bgtw9.T2.m7 Bgsng7202.m6 Bgsng7090.m19 Bgtw3.T1.m8 Bgtw3.T2.m9 Bgtw10.T2.m2.dr Bgsng7202.m7 Bgsng7090.m20 Bgtw3.T1.m9 Bgtw3.T2.m9.dr Bgtw10.T2.m3 Bgsng7202.m8 Bgsng7090.m22 Bgtw3.T1.m11 Bgtw3.T2.m10 Bgtw10.T2.m4.dra Bgsng7202.m9 Bgsng7090.m23 Bgtw3.T1.m12 Bgtw3.T2.m11 Bgtw10.T2.m4.drb Bgsng7202.m10 Bgsng7090.m24 Bgtw3.T1.m13 Bgtw3.T2.m12 Bgtw10.T2.m9.dr Bgsng7202.m11 Bgsng7096.m1 Bgtw3.T1.m14 Bgtw3.T2.m13 Bgtw4.T3.m5.dr Bgsng7202.m12 Bgsng7096.m2 Bgtw3.T1.m15 Bgtw3.T2.m14 Bgtw4.T3.m10.dr Bgsng7202.m13 Bgsng7096.m3 Bgtw3.T1.m16 Bgtw3.T2.m15 Bgsng7001.m19 Bgsng7202.m14 Bgsng7096.m4 Bgtw3.T1.m17 Bgtw3.T2.m16 Bgsng7004.m19 Bgsng7202.m15 Bgsng7096.m5 Bgtw3.T1.m19 Bgtw3.T2.m17 Bgsng7031.m19 Bgsng7202.m16 Bgsng7096.m6 Bgtw3.T1.m20 Bgtw3.T2.m19 Bgsng7050.m19 Bgsng7202.m17 Bgsng7096.m7 Bgtw3.T1.m21 Bgtw3.T2.m20 Bgsng7074.m19 Bgsng7202.m18 Bgsng7096.m8 Bgtw3.T1.m22 Bgtw3.T2.m21 Bgsng7081.m19 Bgsng7202.m20 Bgsng7096.m10 Bgtw4.T1.m1 Bgtw3.T2.m22 Bgsng7087.m19 Bgsng7145.m19 Bgsng7096.m11 Bgtw4.T1.m2 Bgtw4.T2.m1 Bgsng7094.m19 Bgsng7152.m19 Bgsng7096.m12 Bgtw4.T1.m3 Bgtw4.T2.m2 Bgsng7108.m18 Bgsng7203.m19 Bgsng7096.m14 Bgtw4.T1.m4 Bgtw4.T2.m3 Bgsng7109.m18 Bgsng7133.m19 Bgsng7123.m18 Bgsng7110.m18 Bgsng7135.m19 Bgsng7130.m19 Bgsng7116.m19

TABLE 18 History of recruitment for patients for cholera study Reason for Exclusion: History of Presenta- Number of antibiotic Negative tion >24 h individuals No usage ≤1 Dark Field Residence after satisfying Total permanent week prior to test for outside of initiation enrollment Date screened address presentation V. cholerae Dhaka of diarrhea criteria July, 2010 30 7 11 1 7 3 1 August, 2010 38 6 19 3 5 3 2 September, 2010 30 4 10 4 8 4 0 October, 2010 94 11 55 7 7 7 7 November, 2010 163 9 141 0 7 5 1 December, 2010 50 6 36 0 4 4 0 January, 2011 49 4 38 0 5 2 0 February, 2011 51 7 37 0 3 4 0 March, 2011 59 4 47 0 3 5 0 April, 2011 94 6 77 0 7 4 0 May, 2011 84 9 65 0 5 5 0 June, 2011 96 11 76 0 4 5 0 July, 2011 116 17 82 0 9 8 0 August, 2011 199 31 102 0 25 41 0 Total 1153 132 796 15 99 100 11* *4 individuals lost to follow-up after hospital phase

TABLE 19 Summary of fecal samples collected for study First diarrheal Total number Total Average stool (hours Time in of fecal Diar- number of Pa- before Hospital samples rhea samples/h tientID admission)* (h) collected time (h) in hospital A 5 70 103 76 1.5 B 11 49 57 60 1.2 C 6 33 114 39 3.5 D 11 27 21 38 0.8 E 5 34 69 39 2.0 F 9 54 35 62 0.7 G 9 24 29 33 1.2 *Sample not collected

TABLE 20 Correlation of relative abundance of species in fecal samples to time in healthy Bangladeshi children and adults with cholera Spearman r (relative Spearman r (relative abundance versus abundance versus p-value (Benjamini- time after enrollment in chronological age) in p-value (Benjamini- Hochberg corrected, study) in adults with healthy Bangladeshi Hochberg corrected, healthy children Species cholera children cholera dataset) dataset) Streptococcus parasanguinis −0.512511796 −0.050103401 2.26E−16 1.73E−01 Streptococcus; Other −0.456793856 −0.023206263 5.12E−13 5.24E−01 Staphylococcus; Other −0.370912336 −0.427410828 1.02E−08 1.34E−34 Streptococcus thermophilus −0.342273555 −0.302003888 1.50E−07 3.50E−17 Haemophilus parainfluenzae −0.341788561 0.485691395 1.50E−07 1.61E−45 Enterococcus; Other −0.101226118 −0.101736034 1.34E−01 5.41E−03 Escherichia coli −0.051171255 −0.291290688 4.50E−01 4.81E−16 Weissella cibaria −0.050569847 0.267047127 4.50E−01 1.22E−13 Ruminococcus torques −0.011293356 0.576732028 8.63E−01 2.16E−67 Enterococcus faecalis 0.067644949 −0.105616125 3.24E−01 3.97E−03 Lactobacillus reuteri 0.108009698 −0.122581566 1.11E−01 8.19E−04 Clostridium ramosum 0.14039172 0.124957472 3.61E−02 6.62E−04 Dialister; Other 0.145288932 0.525226374 3.07E−02 3.07E−54 Enterobacteriaceae; Other 0.165007089 −0.279516196 1.37E−02 7.58E−15 Lactobacillus mucosae 0.175748083 0.205831988 8.62E−03 1.53E−08 Dorea longicatena 0.1847875 0.644770498 5.75E−03 6.07E−89 Bacteroides fragilis 0.202115079 0.167168648 2.43E−03 4.69E−06 Dorea formicigenerans 0.207317889 0.642324047 1.90E−03 3.69E−88 Prevotella; Other 0.239978967 0.529655297 2.84E−04 2.90E−55 Eubacterium desmolans 0.256993011 0.6126782 9.63E−05 3.55E−78 Ruminococcus obeum 0.272979694 0.538363585 3.25E−05 2.60E−57 Megamonas; Other 0.280339656 0.262466461 1.97E−05 3.20E−13 Bifidobacterium bifidum 0.304172965 0.202363768 3.18E−06 2.62E−08 Collinsella aerofaciens 0.307743017 0.432321119 2.48E−06 1.97E−35 Prevotella copri 0.316303623 0.544177019 1.26E−06 1.02E−58 Megasphaera; Other 0.333802576 0.164470597 2.83E−07 6.53E−06 Lactobacillus ruminis 0.333863734 0.535215561 2.83E−07 1.41E−56 Ruminococcus sp 5 1 39BFAA 0.354025816 0.661928886 5.24E−08 3.15E−95 Catenibacterium mitsuokai 0.384683801 0.50376204 2.54E−09 2.24E−49 Lactobacillus; Other 0.400088891 0.171080853 4.91E−10 2.84E−06 Eubacterium hallii 0.443162269 0.442782454 2.68E−12 3.19E−37 Ruminococcaceae; Other 0.449971243 0.433092184 1.18E−12 1.52E−35 Clostridium; Other 0.474086343 0.504843768 4.91E−14 1.39E−49 Faecalibacterium prausnitzii 0.481962341 0.710727898 1.73E−14  1.54E−115 Clostridium bartlettii 0.502239897 0.441173741 8.58E−16 5.88E−37 Clostridiales; Other 0.502335879 0.697003842 8.58E−16  1.44E−109 Clostridium disporicum 0.562421244 0.366422526 3.61E−20 3.64E−25 Bifidobacterium longum 0.614285922 −0.455197243 7.47E−25 1.72E−39 Clostridium glycolicum 0.621583288 0.335500578 2.00E−25 4.26E−21 Bifidobacterium; Other 0.683619978 0.368987869 2.18E−32 1.66E−25

TABLE 21 Indicator value analysis results Indicator value(Recovery) - Indicator value(Diarrhea)* Subject Combined (not differentiated Species A B C D E F G by subject) Acidaminococcus intestini NA NA NA NA NA NA NA NA Acidaminococcus; Other 0.438 NA NA NA NA NA NA 0.099 Acidovorax avenae NA NA NA NA NA NA NA NA Acinetobacter baumannii NA NA NA −0.765 −0.929 −0.691  −0.588 −0.478  Acinetobacter calcoaceticus NA NA NA NA NA NA −0.529 −0.210  Acinetobacter johnsonii NA −0.333  NA NA −0.786 NA −0.588 −0.388  Acinetobacter junii NA NA NA NA −0.857 −0.695  −0.706 −0.428  Acinetobacter; Other NA NA NA NA −0.929 −0.481  −0.765 −0.449  Actinobacillus porcinus NA NA NA −0.552 NA −0.333  NA −0.230  Actinomyces georgiae NA NA NA NA NA NA NA NA Actinomyces graevenitzii NA NA NA NA −0.857 NA −0.703 −0.380  Actinomyces odontolyticus NA NA NA NA NA NA −0.917 −0.512  Actinomyces oris NA NA NA NA NA NA −0.702 −0.315  Actinomycetales; Other NA NA NA NA NA NA NA 0.092 Aerococcus; Other NA −0.444  −0.565  NA −0.857 NA −0.529 −0.348  Aeromonas; Other NA NA NA NA −1.000 −0.687  −0.814 −0.442  Afipia genosp 9 NA NA NA NA NA NA NA NA Aggregatibacter segnis NA NA NA −0.881 NA −0.593  NA −0.288  Agrobacterium tumefaciens NA NA NA NA −0.929 NA −0.353 NA Alcaligenaceae; Other NA NA NA NA NA NA NA −0.111  Alistipes finegoldii NA NA NA NA NA 0.250 NA 0.041 Alistipes shahii NA NA NA NA NA 0.250  0.563 0.184 Alistipes sp NML05A004 NA NA NA NA NA 0.375 NA 0.092 Allisonella histaminiformans 0.438 NA NA NA NA NA NA 0.177 Anaerobiospirillum succiniciproducens NA NA NA NA NA NA NA NA Anaerococcus octavius NA 0.561 NA NA NA NA NA 0.088 Anaerococcus vaginalis NA NA NA NA NA NA −0.412 −0.130  Anaeroglobus geminatus NA NA NA NA NA NA NA −0.064  Arcobacter butzleri NA NA NA NA NA NA −0.471 −0.072  Atopobium sp F0209 NA NA NA NA −0.750 NA −0.757 −0.387  Atopobium; Other NA NA NA NA NA NA NA −0.051  Azospirillum; Other NA NA NA NA NA NA NA NA Bacillaceae; Other NA NA NA NA NA NA NA NA Bacillales; Other NA −0.500  −1.000  NA −0.857 −0.593  −0.572 −0.529  Bacilli; Other NA NA NA NA NA −0.667  NA −0.274  Bacillus sp 01082 NA NA NA −0.949 NA −0.962  −0.877 −0.667  Bacillus; Other NA NA NA NA NA NA −0.471 −0.196  Bacteria; Other 0.803 0.786 0.574 NA NA 0.875  0.567 0.672 Bacteriovorax sp EPA NA NA NA NA NA NA NA −0.065  Bacteriovorax sp F2 NA NA NA NA NA NA NA NA Bacteroidales; Other 0.422 0.999 0.500 NA NA 0.911  0.920 0.700 Bacteroides caccae NA NA NA NA NA NA NA 0.143 Bacteroides fragilis 0.625 NA 0.440  0.676 NA NA NA 0.445 Bacteroides galacturonicus 0.563 NA 0.834  0.929 NA 0.674  0.421 0.547 Bacteroides ovatus 0.438 0.833 NA NA  0.712 NA  0.736 0.460 Bacteroides plebeius 0.250 0.431 NA  0.784  0.713 0.830  0.937 0.600 Bacteroides sp CIP103040 NA NA NA NA NA 0.496 NA 0.112 Bacteroides stercoris 0.250 NA NA NA  0.571 NA NA 0.208 Bacteroides uniformis NA NA NA NA NA 0.250 NA 0.087 Bacteroides vulgatus NA NA NA NA NA 0.450 NA 0.127 Bacteroides; Other 0.302 0.937 NA  0.784 NA NA  0.498 0.549 Bacteroidetes; Other NA 0.938 NA NA NA NA  0.618 0.377 Betaproteobacteria; Other NA NA NA NA NA NA NA 0.092 Bifidobacteriaceae; Other NA NA NA NA NA NA NA NA Bifidobacterium bifidum NA NA 0.462  0.714 NA 0.301 NA 0.275 Bifidobacterium dentium NA NA NA NA −0.923 NA NA −0.158  Bifidobacterium; Other 0.954 0.981 0.995  0.999  0.981 0.985  0.998 0.987 Bilophila wadsworthia NA 0.938 NA NA NA NA  0.735 0.312 Blautia producta NA 0.571 NA NA  0.857 0.313 NA 0.337 Blautia sp M25 NA NA NA NA NA NA −0.353 NA Blautia; Other 0.537 0.676 −0.845   0.848  0.857 0.890 NA 0.669 Brachybacterium paraconglomeratum NA NA NA NA NA NA NA −0.109  Brachybacterium; Other NA NA NA NA NA NA NA −0.114  Brachyspira aalborgi NA NA NA NA −1.000 NA NA −0.101  Brachyspira pilosicoli NA NA NA NA −0.857 NA −0.588 −0.158  Bradyrhizobiaceae; Other NA NA NA NA NA NA NA NA Brevibacterium; Other NA NA NA NA NA NA −0.529 −0.221  Brevundimonas diminuta NA NA NA NA NA NA −0.588 −0.241  Brevundimonas terrae NA NA NA NA NA NA −0.647 −0.202  Brevundimonas vesicularis NA NA NA NA NA NA NA −0.167  Brucellaceae; Other NA NA NA NA NA NA NA −0.086  Butyrivibrio crossotus NA 0.840 NA NA NA NA NA 0.273 Campylobacter hyointestinalis 0.737 NA NA −0.887 NA NA −0.999 −0.686  Campylobacter jejuni NA NA NA −0.889 NA −0.481  NA −0.203  Campylobacter; Other −0.940  NA NA −0.778 NA NA −0.706 −0.476  Catenibacterium mitsuokai 0.745 0.895 0.776 NA NA NA  0.994 0.791 Cerasicoccus arenae NA NA NA NA NA NA NA NA Cetobacterium somerae 0.625 NA NA NA NA −0.684  NA NA Chryseobacterium hominis NA NA NA NA NA NA NA −0.123  Chryseobacterium; Other NA NA NA NA NA NA NA 0.061 Clostridiaceae; Other 0.431 0.805 0.923 NA  0.857 0.373  0.812 0.641 Clostridiales; Other 0.972 0.825 NA NA  0.996 0.695  0.852 0.832 Clostridium bartlettii 0.875 0.903 NA  1.000  0.857 NA NA 0.341 Clostridium bifermentans NA NA NA NA NA NA NA NA Clostridium bolteae NA NA NA NA NA NA  0.796 0.278 Clostridium clostridioforme 0.496 0.553 NA −0.888  0.857 NA  0.963 0.334 Clostridium disporicum 0.749 0.966 0.923  0.999  0.999 0.551 NA 0.699 Clostridium glycolicum 0.563 0.750 0.462  0.643  0.857 0.500  0.750 0.633 Clostridium glycyrrhizinilyticum NA NA −0.680  NA  0.714 0.489 NA NA Clostridium hathewayi NA 0.374 NA NA NA NA  0.875 0.234 Clostridium hylemonae NA NA NA NA NA NA NA NA Clostridium innocuum NA NA NA NA NA NA NA 0.061 Clostridium neonatale NA NA NA NA NA NA NA NA Clostridium nexile 0.250 NA NA NA NA NA NA 0.233 Clostridium paraputrificum 0.983 NA 0.874 NA  0.999 0.472 NA 0.521 Clostridium perfringens NA 0.313 NA  0.714 NA NA NA 0.286 Clostridium ramosum 0.250 NA NA  0.786 NA NA NA 0.247 Clostridium sp L2 50 NA NA NA  0.786 NA NA NA 0.242 Clostridium sp SS2 1 NA 0.563 NA NA NA NA NA 0.122 Clostridium; Other NA 0.681 NA NA NA 0.681  0.820 0.387 Collinsella aerofaciens 0.918 0.883 0.890 NA NA 0.525 NA 0.584 Collinsella; Other 0.438 0.703 0.538 NA NA NA  0.920 0.438 Comamonadaceae; Other NA NA NA NA NA −0.704  −0.824 NA Comamonas aquatica NA NA NA NA NA −0.370  −0.765 −0.343  Comamonas; Other NA NA NA NA NA NA NA 0.082 Coprococcus catus NA 0.950 NA −0.778  0.835 NA  0.772 0.199 Coprococcus comes NA 0.627 NA −0.778 NA 0.652  0.745 0.378 Coprococcus eutactus 0.375 0.812 NA NA NA 0.747  0.851 0.526 Coprococcus; Other 0.250 0.625 NA NA NA 0.625  0.869 0.438 Coriobacteriaceae; Other 0.499 0.956 0.799 NA NA 0.631  0.545 0.600 Corynebacterium aurimucosum NA NA NA NA NA NA NA −0.164  Corynebacterium durum NA NA NA NA NA NA −0.584 −0.245  Corynebacterium imitans NA NA NA NA NA NA −0.412 −0.217  Corynebacterium matruchotii NA NA NA NA NA NA −0.641 −0.311  Corynebacterium mucifaciens NA NA NA NA NA −0.519  NA −0.326  Corynebacterium tuberculostearicum NA NA NA NA NA NA −0.647 −0.492  Corynebacterium; Other −0.300  NA −0.695  NA NA −0.481  −0.706 −0.488  Deltaproteobacteria; Other NA NA NA NA NA NA NA NA Desulfovibrio; Other 0.438 NA NA NA NA NA  0.860 0.274 Dialister invisus NA NA NA NA NA NA NA NA Dialister pneumosintes 0.749 NA NA NA NA 0.551 NA 0.400 Dialister; Other NA NA NA NA NA NA −0.353 −0.109  Dolosigranulum pigrum NA NA NA NA NA NA NA NA Dorea formicigenerans 0.522 0.765 NA −0.836  0.998 0.513  0.909 0.494 Dorea longicatena 0.656 0.624 0.702 −0.751  0.855 NA NA 0.358 Edwardsiella ictaluri NA NA NA NA NA NA NA NA Eggerthella lenta NA NA NA NA NA NA  0.500 0.227 Elusimicrobium minutum NA NA NA NA NA NA −0.706 NA Enterobacteriaceae; Other 0.470 NA NA NA NA −0.510   0.737 NA Enterococcaceae; Other NA NA NA NA NA NA NA −0.177  Enterococcus cecorum NA 0.629 NA NA NA NA NA 0.116 Enterococcus faecalis NA NA NA NA NA NA NA NA Enterococcus; Other NA NA −0.753  NA −0.525 −0.765  −0.750 −0.460  Erysipelotrichaceae; Other NA NA NA NA NA NA NA NA Escherichia albertii NA NA NA NA NA NA NA NA Escherichia coli −0.518  −0.409  NA NA NA −0.361   0.951 −0.345  Escherichia; Other NA NA NA NA NA −0.428   0.890 −0.256  Eubacterium biforme 0.864 NA 0.774 NA  0.996 0.583  0.459 0.712 Eubacterium coprostanoligenes 0.563 0.812 NA NA NA 0.873  0.874 0.530 Eubacterium desmolans NA 0.819 NA NA  0.856 0.589  0.591 0.258 Eubacterium eligens 0.875 0.981 NA  0.786  0.429 0.845 NA 0.696 Eubacterium hallii 0.548 0.993 NA NA NA 0.989  0.969 0.673 Eubacterium limosum NA NA NA NA NA NA NA 0.041 Eubacterium ramulus 0.250 0.872 NA NA NA NA  0.844 0.353 Eubacterium rectale NA 0.919 NA NA NA 0.929  0.830 0.457 Eubacterium saburreum 0.962 0.952 NA NA NA 0.891  0.944 0.769 Eubacterium siraeum NA NA NA NA NA NA −0.529 −0.216  Eubacterium sp cL 10 1 3 NA 0.435 NA NA NA NA  0.869 0.223 Eubacterium; Other 0.500 0.438 0.686 NA NA 0.625  0.931 0.508 Faecalibacterium prausnitzii 0.972 1.000 NA NA  0.857 0.835  0.801 0.860 Faecalibacterium; Other 0.953 0.999 0.876 NA NA 0.697  0.660 0.819 Finegoldia magna NA NA NA NA NA NA NA NA Firmicutes; Other NA 0.902 NA NA NA 0.748  0.947 0.725 Flavobacteriaceae; Other NA NA NA NA NA NA NA NA Flavobacteriales; Other NA NA NA NA NA NA NA NA Flavobacterium; Other NA NA NA NA NA NA NA NA Flexibacter; Other NA NA NA NA NA NA NA 0.091 Fusobacteriaceae; Other NA NA NA NA NA −0.481  NA −0.094  Fusobacterium mortiferum NA −0.996  NA NA NA NA NA −0.786  Fusobacterium nucleatum NA −0.444  NA −1.000 NA −0.641  −0.641 −0.511  Fusobacterium; Other NA −0.996  −0.981  −0.836 NA NA NA −0.879  Gammaproteobacteria; Other NA −0.943  NA NA −0.820 NA −0.412 −0.439  Granulicatella adiacens NA NA −0.746  NA NA −0.705  −0.925 −0.615  Granulicatella elegans NA NA NA −0.742 −0.923 −0.838  NA −0.452  Haemophilus haemolyticus NA NA NA −0.965 NA −0.852  NA −0.463  Haemophilus; Other NA NA NA NA NA −0.667  NA −0.217  Halomonas; Other NA −0.333  NA NA NA NA −0.353 −0.167  Helicobacter cinaedi NA NA NA NA NA NA NA NA Helicobacter winghamensis NA NA NA NA NA −0.556  NA −0.210  Helicobacter; Other NA NA NA NA NA NA NA NA Intrasporangiaceae; Other NA NA NA NA NA NA −0.706 −0.101  Jeotgalicoccus; Other NA −0.444  NA NA NA NA NA −0.217  Kocuria marina NA NA NA NA NA NA NA NA Lachnospira pectinoschiza NA 0.582 NA NA NA NA NA 0.176 Lachnospiraceae; Other 0.563 0.755 NA NA NA 0.708  0.460 0.492 Lactobacillaceae; Other NA NA NA NA NA NA NA NA Lactobacillales; Other NA NA NA NA NA NA NA NA Lactobacillus delbrueckii NA NA NA NA NA NA NA −0.072  Lactobacillus fermentum −0.832  NA NA NA NA NA NA −0.311  Lactobacillus mucosae NA NA 0.308 NA NA NA NA NA Lactobacillus ruminis −0.823  NA 0.769 NA NA NA NA NA Lactobacillus saerimneri NA NA 0.846 NA NA NA NA 0.619 Lactobacillus sp Atm5 NA NA NA NA NA NA NA NA Lactobacillus sp KLDS 1 0716 NA NA NA NA NA NA NA −0.065  Lactobacillus; Other NA NA NA NA NA NA NA NA Lactococcus garvieae NA NA NA NA NA NA NA 0.082 Leptotrichia 591114 NA NA NA NA NA NA NA −0.109  Leptotrichia buccalis NA NA NA NA NA −0.481  NA −0.283  Leptotrichia shahii −0.667  −0.389  −0.609  −0.889 −0.928 −0.908  −0.706 −0.716  Leptotrichia sp PG10 NA NA NA NA NA NA −0.471 −0.130  Leptotrichia; Other NA NA NA NA −0.857 NA NA −0.188  Leptotrichiaceae; Other NA NA NA NA −0.929 −0.741  NA −0.399  Leucobacter komagatae NA NA NA NA NA NA NA 0.102 Leucobacter; Other NA NA NA NA NA NA NA 0.061 Leuconostoc; Other NA NA NA NA NA NA NA NA Luteimonas; Other NA NA NA NA NA NA −0.647 NA Megamonas rupellensis NA NA 0.921  0.786 NA 0.310 NA 0.336 Megamonas; Other NA NA 0.762 NA NA NA NA 0.192 Megasphaera elsdenii 0.687 NA 0.919 NA NA −0.333  NA 0.315 Megasphaera hominis NA NA 0.538 NA NA NA NA 0.102 Megasphaera sp TrE9262 0.437 NA 0.846 NA NA NA NA 0.234 Megasphaera; Other 0.313 NA NA NA NA NA NA 0.092 Micrococcus luteus NA NA NA NA NA NA NA −0.123  Mitsuokella multacida 0.625 0.563 NA NA NA NA NA 0.255 Mitsuokella; Other 0.375 NA NA NA NA NA NA 0.091 Mogibacterium neglectum NA NA NA NA NA NA −0.412 NA Moraxella osloensis NA NA NA NA NA NA NA −0.188  Moraxellaceae; Other NA NA NA NA NA NA NA −0.080  Morganella morganii NA NA NA NA NA NA NA NA Neisseria elongata NA NA NA NA NA NA NA −0.158  Neisseria subflava NA NA NA −0.667 NA −0.444  NA −0.275  Neisseria; Other −0.633  −0.444  −0.564  −0.994 NA −0.660  −0.412 −0.613  Nevskia; Other NA NA NA NA NA NA NA NA Novosphingobium; Other NA NA NA NA NA NA NA NA Odoribacter splanchnicus NA NA NA NA NA NA  0.419 0.129 Olsenella sp A2 0.500 0.995 NA NA NA NA NA 0.306 Olsenella; Other 0.500 NA NA NA NA NA NA 0.092 Oribacterium sp oral taxon 108 NA NA NA NA NA NA −0.353 −0.180  Oscillibacter sp G2 NA 0.563 NA NA NA NA  0.681 0.244 Oscillibacter; Other NA 0.938 NA −0.667 NA 0.791 NA 0.304 Oxalobacter formigenes NA NA NA NA NA NA NA 0.051 Pantoea ananatis NA NA NA NA NA NA NA NA Parabacteroides distasonis NA 0.375 NA NA NA 0.616  0.500 0.326 Parabacteroides merdae NA NA NA NA NA 0.375 NA 0.092 Parabacteroides; Other 0.438 0.688 NA NA NA 0.500  0.938 0.429 Paracoccus denitrificans NA NA NA NA −0.786 NA −0.471 −0.167  Paracoccus; Other NA NA NA NA NA NA NA NA Pasteurellaceae; Other NA NA −0.770  NA NA −0.870  −0.689 −0.568  Pediococcus; Other NA NA NA NA NA NA NA NA Pedobacter terrae NA NA NA NA NA NA NA −0.116  Pedobacter; Other NA NA NA NA NA NA NA 0.071 Peptoniphilus harei NA NA NA NA NA NA NA NA Peptostreptococcus stomatis NA NA NA NA NA NA NA NA Peptostreptococcus; Other NA NA NA −0.889 NA −0.543  −0.647 −0.396  Peredibacter starrii NA NA NA NA NA NA NA NA Phascolarctobacterium faecium NA NA NA NA NA 0.313  0.419 0.122 Phascolarctobacterium succinatutens NA 0.998 0.615 −0.667 NA NA NA 0.383 Porphyromonas catoniae NA NA NA −0.778 NA NA NA −0.290  Prevotella buccae NA NA NA NA NA NA NA NA Prevotella copri 0.920 0.994 0.900 NA NA 0.925 NA 0.776 Prevotella denticola NA NA NA NA NA NA NA −0.094  Prevotella histicola NA −0.611  −0.478  −1.000 −0.929 −0.963  −0.706 −0.667  Prevotella nanceiensis NA NA NA −0.889 NA −0.519  NA −0.268  Prevotella oulorum 0.966 0.969 NA NA NA 0.742 NA 0.520 Prevotella salivae NA NA NA NA NA NA NA −0.145  Prevotella sp DJF B112 NA −0.389  NA NA NA −0.630  −0.588 −0.341  Prevotella sp DJF B116 0.560 0.938 0.754 −0.540 NA 0.915  0.726 0.633 Prevotella sp DJF CP65 0.492 0.927 NA −0.641 NA 0.789  0.481 0.453 Prevotella sp DJF LS16 0.500 NA NA NA NA NA NA 0.092 Prevotella sp oral taxon 302 0.531 0.426 NA −0.674 NA 0.857 NA 0.280 Prevotella sp RS2 0.312 0.937 NA NA NA NA NA 0.214 Prevotella stercorea NA 0.976 NA −0.889 NA 0.788 −0.684 NA Prevotella veroralis NA NA NA NA NA NA NA 0.139 Prevotella; Other NA −0.500  NA NA NA −0.593  −0.647 −0.391  Prevotellaceae; Other NA 0.500 NA NA NA NA NA 0.199 Prosthecobacter; Other NA NA NA NA NA NA NA NA Proteobacteria; Other −0.691  −0.450  NA NA NA −0.634   0.911 −0.501  Proteus mirabilis NA NA NA NA NA NA NA NA Pseudomonas mendocina NA −0.778  NA NA −0.857 NA −0.647 −0.449  Pseudomonas stutzeri −0.400  −0.888  −0.565  NA −1.000 −0.601  −0.913 −0.653  Pseudomonas; Other NA NA NA NA −0.786 NA −0.471 −0.225  Ralstonia; Other NA −0.611  NA NA −0.786 NA NA −0.246  Rheinheimera sp 09BSZB 9 NA NA NA NA NA NA NA −0.130  Rheinheimera sp TPS16 NA NA NA NA NA NA NA NA Rheinheimera; Other NA NA NA NA NA NA −0.353 −0.181  Rhizobiaceae; Other NA NA NA NA NA NA NA 0.081 Rhizobiales; Other NA NA NA NA NA NA NA NA Rhodobacteraceae; Other NA NA NA NA NA NA NA 0.092 Rhodocyclaceae; Other NA NA NA NA NA NA NA NA Roseburia intestinalis 0.561 NA NA NA NA 0.709  0.773 0.562 Roseburia; Other 0.870 0.917 NA NA  0.857 0.628 NA 0.674 Rothia dentocariosa −0.689  NA −0.696  NA NA −0.370  −0.824 −0.557  Rothia mucilaginosa −0.694  NA −0.895  −0.905 −0.947 NA −0.824 −0.706  Ruminococcaceae; Other 0.545 0.999 NA NA NA 0.892  0.979 0.686 Ruminococcus bromii 0.562 0.562 NA NA NA 0.687  0.499 0.479 Ruminococcus callidus 0.500 1.000 NA NA NA 0.872  0.562 0.479 Ruminococcus flavefaciens NA 0.375 NA NA NA NA  0.375 0.133 Ruminococcus gnavus 0.784 NA 0.610  0.714 NA NA NA 0.430 Ruminococcus obeum 0.494 0.908 NA NA  0.851 NA NA 0.301 Ruminococcus sp 5 1 39BFAA 0.812 NA −0.443  NA  0.997 0.950  0.888 0.671 Ruminococcus sp DJF VR70k1 0.874 0.946 NA NA  0.856 0.917  0.668 0.762 Ruminococcus sp ZS2 15 NA NA NA NA  0.857 NA NA 0.124 Ruminococcus torques 0.369 0.688 NA NA NA 0.687  0.250 0.337 Ruminococcus; Other NA NA NA NA  0.992 0.563  0.801 NA Salmonella enterica NA NA NA NA NA NA NA NA Sarcina ventriculi NA NA NA NA NA NA NA NA Sarcina; Other NA NA NA NA NA NA NA 0.092 Scardovia wiggsiae NA NA NA NA NA NA NA −0.130  Shinella; Other NA NA NA NA NA NA NA NA Shuttleworthia satelles NA NA NA NA NA NA NA −0.085  Slackia isoflavoniconvertens 0.250 0.757 0.613 NA NA 0.646  0.611 0.465 Solobacterium moorei NA NA NA NA NA −0.538  −0.529 −0.320  Sphingobacterium mizutaii NA NA NA NA NA NA −0.706 −0.123  Sphingobacterium multivorum NA NA NA NA NA NA −0.294 −0.130  Sphingobacterium sp P 7 NA NA NA NA NA NA NA NA Sphingobium yanoikuyae NA NA NA NA NA NA NA −0.196  Sphingomonadaceae; Other NA NA NA NA NA NA NA −0.058  Sphingomonadales; Other NA NA NA NA NA NA NA 0.061 Sphingomonas sp BAC84 NA −0.535  NA NA NA NA NA −0.156  Sphingomonas yabuuchiae NA NA NA NA NA NA NA NA Sphingomonas; Other NA NA NA NA NA NA NA −0.072  Staphylococcaceae; Other NA NA NA NA NA NA NA −0.087  Staphylococcus aureus NA −0.667  −0.957  NA −1.000 −0.535  −0.699 −0.621  Staphylococcus; Other NA −0.333  −0.913  NA −1.000 NA −0.646 −0.478  Stenotrophomonas maltophilia NA NA NA NA −0.857 NA −0.471 −0.283  Stenotrophomonas rhizophila NA NA NA NA NA NA −0.765 −0.275  Stenotrophomonas; Other −0.733  −0.936  −0.669  NA NA NA NA −0.423  Streptococcaceae; Other −0.585  NA 0.385 NA NA NA NA NA Streptococcus anginosus −0.926  NA NA NA −0.779 −0.810  −0.584 −0.629  Streptococcus gordonii −0.790  NA NA NA −0.867 −0.740  −0.880 −0.679  Streptococcus mutans NA NA NA NA NA NA NA −0.203  Streptococcus parasanguinis −0.797  −0.624  −0.665  NA NA −0.856  −0.718 −0.663  Streptococcus peroris −0.944  NA −0.818  NA NA NA −0.997 −0.738  Streptococcus sanguinis NA NA NA NA NA NA NA NA Streptococcus thermophilus −0.913  −0.333  −0.901  NA −0.962 NA −0.882 −0.721  Streptococcus; Other −0.953  NA NA NA −0.941 NA −0.984 −0.562  Subdoligranulum variabile NA 1.000 NA −0.622 NA 0.986  0.652 0.498 Succinivibrio dextrinosolvens NA NA NA NA NA NA −0.765 NA Sutterella sp YIT 12072 NA 0.791 NA NA NA 0.583 NA NA Sutterella stercoricanis NA 0.563 NA NA NA NA −0.601 NA Sutterella; Other 0.704 −0.883  NA −0.881 NA NA −0.825 −0.393  Thauera terpenica NA NA NA NA NA NA NA 0.071 Thauera; Other NA NA NA NA NA NA NA NA Thermus igniterrae NA NA NA NA NA NA NA NA Treponema porcinum NA NA NA NA NA NA NA NA Treponema succinifaciens NA NA NA NA NA NA NA NA Turicibacter sanguinis 0.563 0.812 0.692 NA  1.000 0.438  0.375 0.612 unclassified_Erysipelotrichaceae; Other 0.402 NA NA NA NA NA NA 0.156 Ureaplasma; Other NA NA NA NA NA NA NA NA Varibaculum cambriense NA NA NA NA NA NA NA NA Veillonella dispar NA NA NA NA NA −0.811  −0.999 −0.537  Veillonella parvula NA NA NA −0.822 NA −0.762  −0.812 NA Veillonella sp S101 NA NA NA −0.865 NA −0.669  −0.761 −0.302  Veillonella; Other NA NA NA NA NA NA NA −0.130  Veillonellaceae; Other 0.611 NA 0.766 NA NA NA −0.641 0.259 Verrucomicrobium sp IRVE NA NA NA NA NA NA NA NA Vibrio cholerae −0.997  −0.997  NA −0.998 −0.999 −0.966  −0.999 −0.990  Vibrio; Other −0.499  NA NA −0.888 −0.786 −0.481  −0.941 −0.521  Wautersiella falsenii NA NA NA NA NA NA NA NA Weissella cibaria NA 0.313 NA NA NA NA NA NA Weissella; Other NA NA NA NA NA 0.309 NA NA X1760; Other 0.500 0.938 0.385 NA NA 0.492  0.674 0.486 Xanthomonadaceae; Other NA NA NA NA NA NA −0.353 NA FDR-adjusted p-value for indicator value analysis (NA = not observed in individual) Subject Combined (not differentiated by subject, ns = not Species A B C D E F G significant) Acidaminococcus intestini 0.171 NA 0.479 NA NA NA NA ns Acidaminococcus; Other 0.013 0.341 1.000 NA NA NA NA 0.003 Acidovorax avenae NA NA NA 0.211 1.000 NA NA ns Acinetobacter baumannii 0.395 0.341 0.054 0.044 0.024 0.012 0.011 0.000 Acinetobacter calcoaceticus NA 1.000 0.130 NA 0.121 0.572 0.011 0.000 Acinetobacter johnsonii 0.099 0.039 0.077 1.000 0.041 0.217 0.011 0.000 Acinetobacter junii 0.163 0.085 0.571 0.398 0.024 0.012 0.011 0.000 Acinetobacter; Other 0.223 0.091 0.096 0.267 0.024 0.023 0.011 0.000 Actinobacillus porcinus 0.422 NA 0.125 0.026 NA 0.041 0.127 0.000 Actinomyces georgiae NA NA NA NA 0.570 NA 0.133 ns Actinomyces graevenitzii 0.107 0.212 0.194 0.600 0.024 0.110 0.011 0.000 Actinomyces odontolyticus 0.707 0.624 0.096 0.791 0.329 0.081 0.011 0.000 Actinomyces oris 0.268 0.978 0.624 1.000 0.202 0.410 0.011 0.001 Actinomycetales; Other NA NA NA 0.078 1.000 NA NA 0.007 Aerococcus; Other NA 0.028 0.040 NA 0.024 0.126 0.011 0.000 Aeromonas; Other 0.613 0.166 0.254 0.968 0.024 0.012 0.011 0.000 Afipia genosp 9 NA 1.000 1.000 0.085 0.196 NA 0.137 ns Aggregatibacter segnis 1.000 0.787 0.314 0.026 0.446 0.012 0.159 0.000 Agrobacterium tumefaciens NA NA 0.637 0.168 0.041 NA 0.019 ns Alcaligenaceae; Other NA 0.166 0.644 0.422 0.121 1.000 1.000 0.009 Alistipes finegoldii NA NA NA NA NA 0.041 NA 0.021 Alistipes shahii NA 0.079 0.479 NA NA 0.041 0.011 0.000 Alistipes sp NML05A004 NA 0.185 NA NA NA 0.012 NA 0.000 Allisonella histaminiformans 0.013 0.091 1.000 1.000 NA 0.176 1.000 0.001 Anaerobiospirillum succiniciproducens 0.546 NA NA 1.000 NA NA NA ns Anaerococcus octavius 1.000 0.028 NA NA NA NA NA 0.008 Anaerococcus vaginalis NA NA 0.357 0.648 0.329 NA 0.011 0.000 Anaeroglobus geminatus NA 1.000 NA NA 0.626 NA 0.079 0.036 Arcobacter butzleri NA NA NA NA NA 0.643 0.011 0.021 Atopobium sp F0209 0.671 0.624 0.470 0.600 0.041 0.081 0.011 0.000 Atopobium; Other NA NA NA NA 0.224 NA 1.000 0.040 Azospirillum; Other NA 0.403 NA NA 1.000 NA NA ns Bacillaceae; Other 0.436 0.687 NA NA NA NA NA ns Bacillales; Other 1.000 0.015 0.026 0.130 0.041 0.012 0.011 0.000 Bacilli; Other 0.436 0.832 0.561 0.568 0.219 0.012 0.133 0.000 Bacillus sp 01082 0.065 0.127 0.308 0.026 0.104 0.012 0.011 0.000 Bacillus; Other NA 0.415 0.615 NA 0.070 0.553 0.011 0.000 Bacteria; Other 0.013 0.015 0.040 0.068 0.129 0.012 0.011 0.000 Bacteriovorax sp EPA NA 0.296 1.000 NA 0.353 NA 1.000 0.027 Bacteriovorax sp F2 NA 0.683 NA NA 0.657 NA NA ns Bacteroidales; Other 0.013 0.015 0.040 0.648 0.570 0.012 0.011 0.000 Bacteroides caccae 0.469 0.059 NA 1.000 0.157 0.232 0.261 0.000 Bacteroides fragilis 0.013 0.789 0.040 0.026 0.612 0.982 1.000 0.001 Bacteroides galacturonicus 0.013 1.000 0.026 0.026 0.471 0.012 0.019 0.000 Bacteroides ovatus 0.013 0.015 0.130 0.981 0.024 0.511 0.011 0.000 Bacteroides plebeius 0.035 0.039 0.117 0.026 0.024 0.012 0.011 0.000 Bacteroides sp CIP103040 NA NA NA 0.541 NA 0.012 NA 0.001 Bacteroides stercoris 0.045 1.000 NA 0.055 0.024 0.952 0.147 0.001 Bacteroides uniformis NA 0.334 0.479 NA NA 0.041 NA 0.004 Bacteroides vulgatus 0.436 0.069 NA NA NA 0.012 NA 0.000 Bacteroides; Other 0.045 0.015 0.088 0.044 NA 0.095 0.011 0.000 Bacteroidetes; Other 0.436 0.015 0.644 0.403 0.657 0.958 0.019 0.000 Betaproteobacteria; Other NA NA NA 0.055 NA NA NA 0.003 Bifidobacteriaceae; Other NA NA NA NA 0.471 NA NA ns Bifidobacterium bifidum 0.436 0.085 0.026 0.044 0.866 0.041 1.000 0.000 Bifidobacterium dentium 0.324 1.000 0.130 0.127 0.024 NA 0.065 0.041 Bifidobacterium; Other 0.013 0.015 0.026 0.026 0.024 0.012 0.011 0.000 Bilophila wadsworthia NA 0.015 0.479 NA 1.000 0.102 0.011 0.000 Blautia producta 0.123 0.015 0.188 0.068 0.024 0.033 0.099 0.000 Blautia sp M25 NA NA NA NA NA 0.088 0.036 ns Blautia; Other 0.013 0.015 0.026 0.026 0.024 0.012 0.835 0.000 Brachybacterium paraconglomeratum 1.000 0.624 1.000 NA 0.250 1.000 0.284 0.001 Brachybacterium; Other NA 1.000 0.590 1.000 0.121 1.000 1.000 0.000 Brachyspira aalborgi NA NA NA NA 0.024 NA NA 0.000 Brachyspira pilosicoli NA NA NA 1.000 0.024 NA 0.011 0.000 Bradyrhizobiaceae; Other NA NA 0.644 0.085 0.580 NA NA ns Brevibacterium; Other NA 1.000 0.117 0.434 0.070 0.646 0.011 0.000 Brevundimonas diminuta 1.000 0.212 0.117 0.648 0.139 0.581 0.011 0.000 Brevundimonas terrae 1.000 1.000 0.200 1.000 0.224 0.620 0.011 0.000 Brevundimonas vesicularis NA 0.119 0.637 NA 0.104 0.397 0.072 0.000 Brucellaceae; Other NA 1.000 NA 1.000 0.121 NA 0.314 0.009 Butyrivibrio crossotus NA 0.015 NA NA NA 0.067 0.223 0.000 Campylobacter hyointestinalis 0.013 0.172 0.832 0.044 0.189 0.782 0.011 0.001 Campylobacter jejuni 0.555 NA 0.479 0.026 1.000 0.033 0.057 0.001 Campylobacter; Other 0.013 0.624 NA 0.026 0.104 0.769 0.011 0.000 Catenibacterium mitsuokai 0.013 0.015 0.026 1.000 0.525 0.515 0.011 0.000 Cerasicoccus arenae NA 0.613 NA NA NA NA 0.566 ns Cetobacterium somerae 0.013 0.212 0.652 0.434 1.000 0.012 1.000 ns Chryseobacterium hominis NA NA 0.644 0.600 0.248 0.190 1.000 0.001 Chryseobacterium; Other NA NA NA 0.168 NA NA NA 0.040 Clostridiaceae; Other 0.013 0.015 0.026 0.127 0.024 0.012 0.011 0.000 Clostridiales; Other 0.013 0.015 0.791 0.355 0.024 0.012 0.011 0.000 Clostridium bartlettii 0.013 0.015 0.605 0.026 0.024 0.531 1.000 0.007 Clostridium bifermentans 0.436 NA NA NA NA NA 0.142 ns Clostridium bolteae 0.207 0.110 0.479 0.666 0.242 0.297 0.011 0.000 Clostridium clostridioforme 0.013 0.039 0.776 0.026 0.024 0.705 0.011 0.006 Clostridium disporicum 0.013 0.015 0.026 0.026 0.024 0.012 0.284 0.000 Clostridium glycolicum 0.013 0.015 0.026 0.044 0.024 0.012 0.011 0.000 Clostridium glycyrrhizinilyticum NA 0.637 0.026 0.055 0.024 0.012 0.137 ns Clostridium hathewayi 0.436 0.039 NA 1.000 0.446 NA 0.011 0.000 Clostridium hylemonae NA NA 0.517 NA NA NA NA ns Clostridium innocuum NA NA NA 0.127 NA NA NA 0.036 Clostridium neonatale NA NA NA NA NA NA 0.476 ns Clostridium nexile 0.013 0.310 NA 0.648 NA 0.851 0.133 0.008 Clostridium paraputrificum 0.013 0.624 0.026 0.597 0.024 0.033 0.072 0.000 Clostridium perfringens 0.218 0.049 0.054 0.026 0.084 0.060 NA 0.000 Clostridium ramosum 0.035 0.140 0.117 0.026 NA 0.508 0.576 0.001 Clostridium sp L2 50 0.436 0.420 1.000 0.026 0.094 0.236 0.057 0.006 Clostridium sp SS2 1 0.436 0.015 NA NA NA 0.232 NA 0.000 Clostridium; Other 0.679 0.015 0.164 1.000 NA 0.012 0.011 0.000 Collinsella aerofaciens 0.013 0.015 0.026 0.095 0.582 0.012 0.142 0.000 Collinsella; Other 0.013 0.015 0.026 NA NA 0.102 0.011 0.000 Comamonadaceae; Other 1.000 0.637 0.593 0.055 0.094 0.012 0.011 ns Comamonas aquatica 0.657 0.231 0.117 0.648 0.070 0.041 0.011 0.000 Comamonas; Other NA NA NA 0.078 NA NA NA 0.008 Coprococcus catus 0.838 0.015 0.054 0.026 0.024 0.901 0.011 0.023 Coprococcus comes 0.082 0.015 0.155 0.026 1.000 0.012 0.011 0.000 Coprococcus eutactus 0.013 0.015 NA 0.130 0.471 0.012 0.011 0.000 Coprococcus; Other 0.013 0.015 NA 0.203 NA 0.012 0.011 0.000 Coriobacteriaceae; Other 0.013 0.015 0.026 0.125 0.582 0.012 0.011 0.000 Corynebacterium aurimucosum NA 0.687 0.212 1.000 0.157 0.140 1.000 0.000 Corynebacterium durum 1.000 0.624 0.637 0.722 0.487 0.657 0.011 0.018 Corynebacterium imitans NA 0.133 0.077 NA 0.129 NA 0.019 0.000 Corynebacterium matruchotii 0.056 NA 0.130 0.130 0.369 0.183 0.011 0.000 Corynebacterium mucifaciens 0.630 0.687 0.066 0.575 0.056 0.012 0.052 0.000 Corynebacterium tuberculostearicum 0.240 0.624 0.066 0.068 0.056 0.081 0.011 0.000 Corynebacterium; Other 0.045 0.091 0.026 0.055 0.471 0.012 0.011 0.000 Deltaproteobacteria; Other NA NA NA NA 1.000 NA NA ns Desulfovibrio; Other 0.013 0.091 0.479 NA NA 0.976 0.011 0.000 Dialister invisus 1.000 0.385 1.000 NA 1.000 1.000 0.133 ns Dialister pneumosintes 0.013 0.085 0.096 1.000 0.695 0.041 1.000 0.001 Dialister; Other NA 1.000 1.000 0.327 0.626 0.429 0.019 0.003 Dolosigranulum pigrum NA NA NA NA 0.692 NA NA ns Dorea formicigenerans 0.013 0.015 0.479 0.026 0.024 0.012 0.011 0.000 Dorea longicatena 0.013 0.015 0.040 0.044 0.024 0.864 1.000 0.000 Edwardsiella ictaluri NA NA NA 0.571 NA NA NA ns Eggerthella lenta NA 0.314 NA 0.078 0.471 0.204 0.011 0.000 Elusimicrobium minutum 0.436 0.613 NA NA NA NA 0.011 ns Enterobacteriaceae; Other 0.013 0.337 0.112 0.078 0.721 0.033 0.019 ns Enterococcaceae; Other NA NA 0.096 0.257 0.129 0.556 0.133 0.000 Enterococcus cecorum 0.218 0.028 0.370 0.427 NA 0.076 NA 0.041 Enterococcus faecalis 0.073 0.185 0.992 0.068 0.309 0.095 0.085 ns Enterococcus; Other 0.149 0.314 0.026 1.000 0.041 0.012 0.011 0.000 Erysipelotrichaceae; Other 0.207 0.613 0.096 0.929 1.000 0.140 0.127 ns Escherichia albertii NA NA NA 1.000 NA 0.353 NA ns Escherichia coli 0.025 0.049 0.538 1.000 0.821 0.012 0.011 0.000 Escherichia; Other 0.383 0.085 0.791 0.713 0.657 0.012 0.011 0.006 Eubacterium biforme 0.013 1.000 0.040 0.264 0.024 0.012 0.011 0.000 Eubacterium coprostanoligenes 0.013 0.015 0.479 NA 0.471 0.012 0.011 0.000 Eubacterium desmolans 0.163 0.015 0.787 0.897 0.024 0.012 0.011 0.008 Eubacterium eligens 0.013 0.015 0.125 0.026 0.041 0.012 0.425 0.000 Eubacterium hallii 0.013 0.015 0.125 0.812 1.000 0.012 0.011 0.000 Eubacterium limosum 0.436 NA 0.517 NA NA NA 0.287 0.039 Eubacterium ramulus 0.025 0.015 NA NA NA 0.088 0.011 0.000 Eubacterium rectale 0.679 0.015 1.000 1.000 NA 0.012 0.011 0.000 Eubacterium saburreum 0.013 0.015 0.308 0.466 0.149 0.012 0.011 0.000 Eubacterium siraeum NA 0.218 NA NA 0.070 0.095 0.011 0.000 Eubacterium sp cL 10 1 3 0.436 0.039 NA NA NA NA 0.011 0.000 Eubacterium; Other 0.013 0.015 0.026 1.000 NA 0.012 0.011 0.000 Faecalibacterium prausnitzii 0.013 0.015 0.054 0.095 0.024 0.012 0.011 0.000 Faecalibacterium; Other 0.013 0.015 0.040 0.314 0.115 0.012 0.011 0.000 Finegoldia magna NA 0.542 0.066 NA 0.297 1.000 NA ns Firmicutes; Other 0.683 0.015 0.225 0.373 0.467 0.012 0.011 0.000 Flavobacteriaceae; Other NA 0.655 1.000 NA 0.336 NA 0.576 ns Flavobacteriales; Other NA NA NA 0.689 1.000 NA NA ns Flavobacterium; Other NA NA NA NA 0.657 NA NA ns Flexibacter; Other NA NA NA 0.078 NA NA 0.284 0.032 Fusobacteriaceae; Other 0.453 0.655 NA NA NA 0.023 NA 0.007 Fusobacterium mortiferum 0.345 0.015 0.138 0.130 0.340 0.349 0.137 0.000 Fusobacterium nucleatum 0.082 0.015 0.320 0.026 0.104 0.012 0.011 0.000 Fusobacterium; Other 0.065 0.015 0.026 0.044 0.231 1.000 0.323 0.000 Gammaproteobacteria; Other 0.254 0.015 0.077 0.541 0.024 0.076 0.028 0.000 Granulicatella adiacens 0.065 0.953 0.040 0.373 0.302 0.012 0.011 0.000 Granulicatella elegans NA 0.069 0.066 0.026 0.024 0.012 0.121 0.000 Haemophilus haemolyticus 0.073 0.687 0.112 0.026 0.157 0.012 0.133 0.000 Haemophilus; Other NA NA NA 0.115 0.369 0.012 0.318 0.000 Halomonas; Other NA 0.049 0.637 NA 0.250 0.343 0.044 0.000 Helicobacter cinaedi 0.742 NA 0.066 1.000 NA 0.465 NA ns Helicobacter winghamensis 1.000 1.000 0.428 NA 0.250 0.012 0.273 0.000 Helicobacter; Other NA NA 0.479 NA 0.242 NA NA ns Intrasporangiaceae; Other NA NA NA 1.000 0.657 NA 0.011 0.007 Jeotgalicoccus; Other NA 0.015 0.269 NA 0.115 0.584 0.052 0.000 Kocuria marina 0.657 1.000 NA NA NA NA 1.000 ns Lachnospira pectinoschiza 0.933 0.039 0.249 NA NA 0.572 0.278 0.001 Lachnospiraceae; Other 0.013 0.015 0.244 0.267 0.471 0.012 0.028 0.000 Lactobacillaceae; Other NA NA 0.112 0.373 0.636 NA NA ns Lactobacillales; Other 0.218 0.687 0.249 0.055 0.056 0.654 0.057 ns Lactobacillus delbrueckii NA NA NA NA 0.094 NA NA 0.022 Lactobacillus fermentum 0.013 1.000 0.479 NA 0.056 0.346 NA 0.000 Lactobacillus mucosae 0.502 0.708 0.040 0.095 0.139 NA 1.000 ns Lactobacillus ruminis 0.013 0.085 0.026 0.085 0.471 0.508 0.866 ns Lactobacillus saerimneri 0.621 0.172 0.026 0.095 0.219 0.277 0.462 0.002 Lactobacillus sp Atm5 NA NA NA 1.000 NA NA NA ns Lactobacillus sp KLDS 1 0716 0.123 NA NA NA NA NA NA 0.018 Lactobacillus; Other 0.598 NA 0.171 0.106 0.104 NA NA ns Lactococcus garvieae NA 0.624 NA 0.203 1.000 0.463 0.566 0.019 Leptotrichia 591114 NA NA 1.000 NA 0.056 NA 0.133 0.000 Leptotrichia buccalis 0.193 0.344 0.244 0.358 0.248 0.012 0.133 0.000 Leptotrichia shahii 0.013 0.028 0.040 0.026 0.024 0.012 0.011 0.000 Leptotrichia sp PG10 NA 0.624 NA NA 0.202 1.000 0.011 0.001 Leptotrichia; Other NA 0.344 NA 0.288 0.024 0.154 0.133 0.000 Leptotrichiaceae; Other 0.282 0.127 0.225 0.115 0.024 0.012 0.284 0.000 Leucobacter komagatae NA NA NA 0.055 NA NA NA 0.002 Leucobacter; Other NA NA NA 0.186 NA NA NA 0.039 Leuconostoc; Other 0.214 0.613 NA 0.384 1.000 0.401 NA ns Luteimonas; Other NA NA NA 0.249 0.582 NA 0.011 ns Megamonas rupellensis 0.073 1.000 0.026 0.026 0.196 0.012 NA 0.000 Megamonas; Other NA NA 0.026 0.115 0.471 1.000 NA 0.000 Megasphaera elsdenii 0.013 0.133 0.026 1.000 0.483 0.023 NA 0.000 Megasphaera hominis 0.131 NA 0.026 NA NA NA NA 0.000 Megasphaera sp TrE9262 0.013 0.091 0.026 NA 1.000 1.000 NA 0.000 Megasphaera; Other 0.013 0.091 NA NA NA NA NA 0.000 Micrococcus luteus NA 0.208 0.479 NA 0.275 1.000 0.566 0.001 Mitsuokella multacida 0.013 0.015 0.858 NA NA 0.067 0.566 0.000 Mitsuokella; Other 0.013 0.613 1.000 NA NA NA 0.566 0.001 Mogibacterium neglectum NA 0.236 0.833 0.130 0.666 1.000 0.011 ns Moraxella osloensis 0.240 0.059 0.637 0.648 0.237 0.611 1.000 0.000 Moraxellaceae; Other NA 0.133 1.000 NA 0.372 NA 0.576 0.015 Morganella morganii NA NA NA 1.000 1.000 NA NA ns Neisseria elongata 0.653 1.000 0.275 0.597 0.626 0.346 0.057 0.001 Neisseria subflava 0.123 0.687 0.117 0.026 0.626 0.012 NA 0.000 Neisseria; Other 0.035 0.015 0.026 0.026 0.084 0.012 0.019 0.000 Nevskia; Other NA NA NA NA 1.000 NA NA ns Novosphingobium; Other NA NA NA NA 0.372 NA NA ns Odoribacter splanchnicus NA NA NA 0.408 1.000 0.081 0.028 0.001 Olsenella sp A2 0.013 0.015 0.066 NA 0.897 NA 0.794 0.000 Olsenella; Other 0.013 0.613 NA NA NA NA NA 0.000 Oribacterium sp oral taxon 108 0.531 0.266 0.496 1.000 0.094 1.000 0.028 0.000 Oscillibacter sp G2 0.436 0.015 NA NA NA 0.088 0.011 0.000 Oscillibacter; Other 0.370 0.015 0.840 0.026 NA 0.012 0.435 0.000 Oxalobacter formigenes 0.436 0.091 NA NA NA NA NA 0.021 Pantoea ananatis 0.653 1.000 NA 1.000 0.613 NA 1.000 ns Parabacteroides distasonis 0.436 0.015 NA 0.125 NA 0.012 0.019 0.000 Parabacteroides merdae 0.436 NA 0.212 NA NA 0.012 NA 0.000 Parabacteroides; Other 0.013 0.015 0.527 NA NA 0.012 0.011 0.000 Paracoccus denitrificans NA NA NA 0.648 0.024 0.429 0.011 0.000 Paracoccus; Other NA 1.000 NA 0.055 0.369 1.000 0.292 ns Pasteurellaceae; Other 0.157 0.909 0.026 1.000 0.329 0.033 0.011 0.000 Pediococcus; Other NA NA 0.479 NA NA NA NA ns Pedobacter terrae NA 0.208 0.644 NA 0.378 1.000 0.137 0.001 Pedobacter; Other NA NA NA 0.127 NA NA NA 0.019 Peptoniphilus harei NA 1.000 0.077 NA 0.471 0.140 0.079 ns Peptostreptococcus stomatis NA 0.687 1.000 NA 0.866 0.228 0.065 ns Peptostreptococcus; Other 1.000 1.000 0.054 0.026 0.237 0.012 0.011 0.000 Peredibacter starrii NA NA NA NA 0.657 NA NA ns Phascolarctobacterium faecium NA NA NA NA NA 0.012 0.011 0.000 Phascolarctobacterium succinatutens NA 0.015 0.026 0.026 0.589 NA 0.085 0.000 Porphyromonas catoniae 0.679 0.069 0.096 0.026 0.570 0.060 0.133 0.000 Prevotella buccae 0.436 NA NA NA NA NA NA ns Prevotella copri 0.013 0.015 0.026 0.479 0.557 0.012 0.165 0.000 Prevotella denticola NA NA 1.000 NA 0.340 0.572 0.057 0.005 Prevotella histicola 0.091 0.015 0.040 0.026 0.024 0.012 0.011 0.000 Prevotella nanceiensis 0.531 0.687 0.200 0.026 0.570 0.012 1.000 0.000 Prevotella oulorum 0.013 0.015 0.112 0.130 0.525 0.012 0.334 0.000 Prevotella salivae NA 0.385 1.000 NA 0.282 0.236 0.057 0.000 Prevotella sp DJF B112 0.531 0.049 0.652 NA 0.129 0.012 0.011 0.000 Prevotella sp DJF B116 0.013 0.015 0.026 0.044 0.471 0.012 0.011 0.000 Prevotella sp DJF CP65 0.013 0.015 0.088 0.026 NA 0.012 0.044 0.000 Prevotella sp DJF LS16 0.013 0.613 NA NA 0.568 NA NA 0.000 Prevotella sp oral taxon 302 0.013 0.039 0.088 0.026 NA 0.012 0.338 0.000 Prevotella sp RS2 0.013 0.015 NA 1.000 0.582 1.000 NA 0.000 Prevotella stercorea 0.229 0.015 0.785 0.026 0.692 0.012 0.036 ns Prevotella veroralis 0.099 1.000 NA NA NA 0.050 0.085 0.002 Prevotella; Other 0.679 0.028 0.288 0.130 0.115 0.012 0.011 0.000 Prevotellaceae; Other 0.436 0.015 0.112 1.000 NA 0.081 0.147 0.003 Prosthecobacter; Other NA 1.000 NA NA 1.000 1.000 NA ns Proteobacteria; Other 0.013 0.028 0.171 1.000 0.860 0.012 0.011 0.000 Proteus mirabilis NA NA NA 1.000 NA NA NA ns Pseudomonas mendocina 0.365 0.015 0.130 0.648 0.024 0.067 0.011 0.000 Pseudomonas stutzeri 0.035 0.015 0.040 0.274 0.024 0.012 0.011 0.000 Pseudomonas; Other NA 0.231 0.593 NA 0.041 0.232 0.019 0.000 Ralstonia; Other NA 0.015 0.146 0.342 0.041 0.372 NA 0.000 Rheinheimera sp 09BSZB 9 NA 0.613 0.593 NA 0.211 0.308 0.297 0.001 Rheinheimera sp TPS16 NA NA NA NA 0.657 NA NA ns Rheinheimera; Other NA 0.403 0.415 0.648 0.224 0.349 0.028 0.000 Rhizobiaceae; Other NA NA NA 0.085 NA NA 0.566 0.032 Rhizobiales; Other NA NA NA NA 0.302 NA NA ns Rhodobacteraceae; Other NA NA NA 0.068 NA NA NA 0.003 Rhodocyclaceae; Other NA NA NA NA 1.000 NA NA ns Roseburia intestinalis 0.013 0.079 0.107 0.650 0.471 0.012 0.011 0.000 Roseburia; Other 0.013 0.015 0.605 0.267 0.024 0.012 0.361 0.000 Rothia dentocariosa 0.013 0.385 0.026 0.358 0.070 0.023 0.011 0.000 Rothia mucilaginosa 0.013 0.185 0.026 0.026 0.024 0.877 0.011 0.000 Ruminococcaceae; Other 0.013 0.015 0.188 0.648 0.471 0.012 0.011 0.000 Ruminococcus bromii 0.013 0.015 NA 0.085 0.681 0.012 0.028 0.000 Ruminococcus callidus 0.013 0.015 NA NA NA 0.012 0.011 0.000 Ruminococcus flavefaciens NA 0.015 NA NA NA 0.475 0.011 0.000 Ruminococcus gnavus 0.013 0.140 0.026 0.026 NA 0.308 0.072 0.000 Ruminococcus obeum 0.013 0.015 0.442 1.000 0.024 0.211 0.570 0.001 Ruminococcus sp 5 1 39BFAA 0.013 0.085 0.040 0.466 0.024 0.012 0.011 0.000 Ruminococcus sp DJF VR70k1 0.013 0.015 0.785 0.085 0.024 0.012 0.011 0.000 Ruminococcus sp ZS2 15 NA NA NA NA 0.024 0.147 NA 0.009 Ruminococcus torques 0.035 0.015 NA NA 0.471 0.012 0.036 0.000 Ruminococcus; Other 0.888 0.960 0.208 0.127 0.024 0.012 0.019 ns Salmonella enterica 0.082 0.357 0.212 0.150 0.896 0.081 0.866 ns Sarcina ventriculi 0.436 0.337 NA NA NA NA NA ns Sarcina; Other 0.177 0.059 NA NA NA 0.228 NA 0.001 Scardovia wiggsiae 0.994 1.000 NA 0.597 0.297 0.410 0.057 0.005 Shinella; Other NA NA NA 0.106 0.582 NA 0.133 ns Shuttleworthia satelles 1.000 1.000 NA NA 0.268 NA 0.284 0.006 Slackia isoflavoniconvertens 0.025 0.015 0.026 1.000 NA 0.012 0.011 0.000 Solobacterium moorei 0.966 0.602 0.138 1.000 0.202 0.012 0.011 0.000 Sphingobacterium mizutaii NA NA NA NA 0.359 NA 0.011 0.001 Sphingobacterium multivorum NA 1.000 0.446 NA 0.167 0.643 0.044 0.001 Sphingobacterium sp P 7 NA NA NA NA 1.000 NA NA ns Sphingobium yanoikuyae NA 0.218 0.254 NA 0.084 0.333 0.099 0.000 Sphingomonadaceae; Other NA 0.624 1.000 NA 0.392 NA 1.000 0.050 Sphingomonadales; Other NA NA NA 0.186 NA NA NA 0.039 Sphingomonas sp BAC84 0.598 0.015 0.239 0.597 0.471 1.000 NA 0.001 Sphingomonas yabuuchiae NA NA NA NA 1.000 NA NA ns Sphingomonas; Other NA NA NA NA 0.398 0.333 0.566 0.014 Staphylococcaceae; Other NA 0.334 1.000 NA 0.443 NA 0.159 0.010 Staphylococcus aureus 0.177 0.015 0.026 0.327 0.024 0.033 0.011 0.000 Staphylococcus; Other 1.000 0.039 0.026 1.000 0.024 0.050 0.011 0.000 Stenotrophomonas maltophilia 1.000 0.377 0.112 0.648 0.024 0.249 0.011 0.000 Stenotrophomonas rhizophila 1.000 1.000 0.107 1.000 0.094 0.343 0.011 0.000 Stenotrophomonas; Other 0.013 0.015 0.026 NA 0.589 NA 1.000 0.000 Streptococcaceae; Other 0.013 NA 0.040 0.127 0.250 NA NA ns Streptococcus anginosus 0.013 1.000 0.194 1.000 0.024 0.012 0.011 0.000 Streptococcus gordonii 0.013 0.079 0.220 0.355 0.041 0.012 0.011 0.000 Streptococcus mutans 0.107 1.000 NA 1.000 0.353 1.000 0.133 0.002 Streptococcus parasanguinis 0.013 0.015 0.026 0.373 0.196 0.012 0.044 0.000 Streptococcus peroris 0.013 0.059 0.026 0.288 0.231 0.176 0.011 0.000 Streptococcus sanguinis NA NA NA NA 1.000 NA NA ns Streptococcus thermophilus 0.013 0.049 0.026 1.000 0.024 0.459 0.011 0.000 Streptococcus; Other 0.013 0.266 0.475 0.889 0.024 0.769 0.011 0.001 Subdoligranulum variabile 0.683 0.015 0.077 0.026 1.000 0.012 0.011 0.000 Succinivibrio dextrinosolvens 1.000 1.000 0.652 1.000 0.626 0.421 0.011 ns Sutterella sp YIT 12072 NA 0.015 0.054 0.994 0.626 0.023 0.472 ns Sutterella stercoricanis 0.679 0.015 NA 0.434 1.000 0.465 0.028 ns Sutterella; Other 0.013 0.015 0.581 0.026 1.000 0.224 0.011 0.004 Thauera terpenica NA NA NA 0.127 NA NA NA 0.019 Thauera; Other NA NA NA 0.378 NA NA NA ns Thermus igniterrae NA NA NA NA 1.000 NA 0.057 ns Treponema porcinum NA NA NA NA 1.000 NA NA ns Treponema succinifaciens NA 0.613 NA NA NA NA 0.287 ns Turicibacter sanguinis 0.013 0.015 0.026 0.055 0.024 0.012 0.011 0.000 unclassified_Erysipelotrichaceae; Other 0.013 0.453 NA 0.085 NA 0.769 0.576 0.004 Ureaplasma; Other 0.679 NA 0.239 NA NA NA NA ns Varibaculum cambriense NA NA NA NA 0.626 NA NA ns Veillonella dispar 0.295 0.133 1.000 0.078 0.121 0.012 0.011 0.001 Veillonella parvula 0.426 0.951 1.000 0.026 0.242 0.012 0.011 ns Veillonella sp S101 0.223 0.991 0.442 0.026 0.149 0.012 0.011 0.015 Veillonella; Other NA 0.180 NA NA 0.056 NA NA 0.000 Veillonellaceae; Other 0.013 0.236 0.026 0.731 0.121 0.983 0.011 0.027 Verrucomicrobium sp IRVE NA NA NA NA 0.626 NA NA ns Vibrio cholerae 0.013 0.015 0.146 0.026 0.024 0.012 0.011 0.000 Vibrio; Other 0.025 0.208 0.288 0.026 0.041 0.041 0.011 0.000 Wautersiella falsenii NA NA 1.000 NA 0.613 NA 0.503 ns Weissella cibaria 0.502 0.028 0.440 1.000 0.847 0.067 0.927 ns Weissella; Other 0.235 0.624 0.466 0.713 0.866 0.041 NA ns X1760; Other 0.013 0.015 0.026 1.000 NA 0.012 0.011 0.000 Xanthomonadaceae; Other NA NA NA 0.055 0.582 NA 0.019 ns

TABLE 22 Correlation between bacterial species abundance in fecal microbiota of cholera patients and the samples' UniFrac distance to healthy adult Bangladeshi fecal communities Indicator FDR adjusted p-value Value(Recovery) − (Benjamini-Hochberg Indicator Species Spearman r P (two-tailed) correction) Value(Diarrhea) Positively Pseudomonas; Other 0.5902 0.0001 0.0002 −0.225 correlated Gammaproteobacteria; Other 0.5856 0.0001 0.0002 −0.439 with Prevotella histicola 0.5265 0.0001 0.0002 −0.667 community Prevotella veroralis 0.5146 0.0001 0.0002 0.139 distance to Pseudomonas mendocina 0.5039 0.0001 0.0002 −0.449 healthy Vibrio cholerae 0.4877 0.0001 0.0002 −0.990 microbiota Prevotella salivae 0.4773 0.0001 0.0002 −0.145 Acinetobacter; Other 0.4392 0.0001 0.0002 −0.449 Vibrio; Other 0.4382 0.0001 0.0002 −0.521 Staphylococcus aureus 0.4381 0.0001 0.0002 −0.621 Leptotrichia; Other 0.4345 0.0001 0.0002 −0.188 Staphylococcus; Other 0.4247 0.0001 0.0002 −0.478 Pseudomonas stutzeri 0.4215 0.0001 0.0002 −0.653 Comamonas aquatica 0.4143 0.0001 0.0002 −0.343 Aerococcus; Other 0.4129 0.0001 0.0002 −0.348 Ralstonia; Other 0.395 0.0001 0.0002 −0.246 Actinomyces graevenitzii 0.3934 0.0001 0.0002 −0.380 Fusobacterium nucleatum 0.3917 0.0001 0.0002 −0.511 Aeromonas; Other 0.3869 0.0001 0.0002 −0.442 Oribacterium sp oral taxon 108 0.3868 0.0001 0.0002 −0.180 Leptotrichiaceae; Other 0.3859 0.0001 0.0002 −0.399 Jeotgalicoccus; Other 0.3842 0.0001 0.0002 −0.217 Acinetobacter johnsonii 0.3819 0.0001 0.0002 −0.388 Stenotrophomonas rhizophila 0.3798 0.0001 0.0002 −0.275 Haemophilus haemolyticus 0.3785 0.0001 0.0002 −0.463 Corynebacterium imitans 0.3656 0.0001 0.0002 −0.217 Bacillus sp 01082 0.3626 0.0001 0.0002 −0.667 Brevundimonas vesicularis 0.3612 0.0001 0.0002 −0.167 Brachyspira pilosicoli 0.3566 0.0001 0.0002 −0.158 Stenotrophomonas maltophilia 0.3513 0.0001 0.0002 −0.283 Veillonella dispar 0.3497 0.0001 0.0002 −0.537 Sphingobium yanoikuyae 0.3494 0.0001 0.0002 −0.196 Halomonas; Other 0.3471 0.0001 0.0002 −0.167 Neisseria subflava 0.3469 0.0001 0.0002 −0.275 Rheinheimera sp TPS16 0.3451 0.0001 0.0002 NA Comamonadaceae; Other 0.3418 0.0001 0.0002 NA Eubacterium saburreum 0.3404 0.0001 0.0002 0.769 Stenotrophomonas; Other 0.3376 0.0001 0.0002 −0.423 Streptococcus anginosus 0.3372 0.0001 0.0002 −0.629 Rothia dentocariosa 0.3356 0.0001 0.0002 −0.557 Brevundimonas diminuta 0.3328 0.0001 0.0002 −0.241 Granulicatella elegans 0.3312 0.0001 0.0002 −0.452 Acinetobacter calcoaceticus 0.3308 0.0001 0.0002 −0.210 Streptococcus gordonii 0.3307 0.0001 0.0002 −0.679 Corynebacterium tuberculostearicum 0.3303 0.0001 0.0002 −0.492 Acinetobacter baumannii 0.3287 0.0001 0.0002 −0.478 Paracoccus denitrificans 0.3256 0.0001 0.0002 −0.167 Fusobacterium; Other 0.3223 0.0001 0.0002 −0.879 Bacillales; Other 0.3213 0.0001 0.0002 −0.529 Veillonella sp S101 0.3209 0.0001 0.0002 −0.302 Acinetobacter junii 0.3192 0.0001 0.0002 −0.428 Leptotrichia sp PG10 0.3153 0.0001 0.0002 −0.130 Moraxellaceae; Other 0.3112 0.0001 0.0002 −0.080 Bacillus; Other 0.3104 0.0001 0.0002 −0.196 Rheinheimera; Other 0.3101 0.0001 0.0002 −0.181 Corynebacterium; Other 0.3083 0.0001 0.0002 −0.488 Leptotrichia shahii 0.3053 0.0001 0.0002 −0.716 Corynebacterium mucifaciens 0.303 0.0001 0.0002 −0.326 Sphingobacterium multivorum 0.3027 0.0001 0.0002 −0.130 Dialister invisus 0.3018 0.0001 0.0002 NA Prevotella oulorum 0.2992 0.0001 0.0002 0.520 Pedobacter; Other 0.2984 0.0001 0.0002 0.071 Brachybacterium; Other 0.2972 0.0001 0.0002 −0.114 Brevundimonas terrae 0.2942 0.0001 0.0002 −0.202 Haemophilus; Other 0.2914 0.0001 0.0002 −0.217 Brevibacterium; Other 0.2885 0.0001 0.0002 −0.221 Neisseria; Other 0.285 0.0001 0.0002 −0.613 Bacteriovorax sp EPA 0.2827 0.0001 0.0002 −0.065 Helicobacter; Other 0.2808 0.0001 0.0002 NA Solobacterium moorei 0.2799 0.0001 0.0002 −0.320 Sphingobacterium mizutaii 0.2785 0.0001 0.0002 −0.123 Brachyspira aalborgi 0.2711 0.0001 0.0002 −0.101 Campylobacter; Other 0.2708 0.0001 0.0002 −0.476 Peptostreptococcus stomatis 0.2705 0.0001 0.0002 NA Shuttleworthia satelles 0.2702 0.0001 0.0002 −0.085 Leptotrichia; 591114 0.2688 0.0001 0.0002 #N/A Lntrasporangiaceae; Other 0.2666 0.0001 0.0002 −0.101 Anaerococcus octavius 0.2663 0.0001 0.0002 0.088 Succinivibrio dextrinosolvens 0.2643 0.0001 0.0002 NA Streptococcus sanguinis 0.2634 0.0001 0.0002 NA Leptotrichia buccalis 0.2627 0.0001 0.0002 −0.283 Porphyromonas catoniae 0.2616 0.0001 0.0002 −0.290 Luteimonas; Other 0.2611 0.0001 0.0002 NA Micrococcus luteus 0.261 0.0001 0.0002 −0.123 Moraxella osloensis 0.2598 0.0001 0.0002 −0.188 Alcaligenaceae; Other 0.2581 0.0001 0.0002 −0.111 Atopobium; Other 0.2545 0.0001 0.0002 −0.051 Brachybacterium paraconglomeratum 0.2535 0.0001 0.0002 −0.109 Staphylococcaceae; Other 0.2517 0.0001 0.0002 −0.087 Streptococcus parasanguinis 0.2515 0.0001 0.0002 −0.663 Rothia mucilaginosa 0.2512 0.0001 0.0002 −0.706 Dialister pneumosintes 0.2495 0.0001 0.0002 0.400 Bifidobacterium dentium 0.2485 0.0001 0.0002 −0.158 Actinomyces oris 0.246 0.0001 0.0002 −0.315 Agrobacterium tumefaciens 0.2441 0.0002 0.0004 NA Corynebacterium aurimucosum 0.2402 0.0002 0.0004 −0.164 Neisseria elongata 0.2371 0.0002 0.0004 −0.158 Prevotella nanceiensis 0.2361 0.0003 0.0006 −0.268 Aggregatibacter segnis 0.2357 0.0003 0.0006 −0.288 Brucellaceae; Other 0.2354 0.0003 0.0006 −0.086 Prevotella denticola 0.2351 0.0003 0.0006 −0.094 Flavobacteriaceae; Other 0.2321 0.0003 0.0006 NA Fusobacterium mortiferum 0.2319 0.0003 0.0006 −0.786 Sphingomonas; Other 0.2259 0.0005 0.0009 −0.072 Bacilli; Other 0.2258 0.0005 0.0009 −0.274 Arcobacter butzleri 0.2245 0.0005 0.0009 −0.072 Elusimicrobium minutum 0.2224 0.0006 0.0011 NA Enterococcus; Other 0.2221 0.0006 0.0011 −0.460 Streptococcus thermophilus 0.2201 0.0007 0.0013 −0.721 Chryseobacterium hominis 0.2187 0.0007 0.0013 −0.123 Azospirillum; Other 0.2168 0.0008 0.0014 NA Thermus igniterrae 0.2156 0.0009 0.0016 NA Wautersiella falsenii 0.2092 0.0012 0.0021 NA Corynebacterium matruchotii 0.208 0.0013 0.0022 −0.311 Lactobacillales; Other 0.2053 0.0015 0.0025 NA Bacteriovorax sp F2 0.2043 0.0016 0.0027 NA Novosphingobium; Other 0.1972 0.0023 0.0038 NA Scardovia wiggsiae 0.1923 0.003 0.0048 −0.130 Anaeroglobus geminatus 0.1921 0.003 0.0048 −0.064 Sphingomonadaceae; Other 0.1907 0.0033 0.0053 −0.058 Lactobacillus fermentum 0.1902 0.0034 0.0054 −0.311 Actinobacillus porcinus 0.189 0.0036 0.0057 −0.230 Helicobacter winghamensis 0.1871 0.0039 0.0061 −0.210 Actinomyces georgiae 0.1851 0.0043 0.0067 NA Veillonella parvula 0.1845 0.0045 0.0070 NA Pantoea ananatis 0.1842 0.0045 0.0070 NA Finegoldia magna 0.1773 0.0063 0.0096 NA Actinomyces graevenitzii 0.1764 0.0066 0.0100 −0.380 Veillonella; Other 0.1764 0.0066 0.0100 −0.130 Rhizobiales; Other 0.1762 0.0067 0.0101 NA Granulicatella adiacens 0.1754 0.0069 0.0104 −0.615 Pasteurellaceae; Other 0.173 0.0077 0.0115 −0.568 Streptococcus; Other 0.1679 0.0098 0.0145 −0.562 Atopobium sp F0209 0.1667 0.0103 0.0152 −0.387 Lactobacillus delbrueckii 0.1658 0.0107 0.0157 −0.072 Bifidobacteriaceae; Other 0.1642 0.0115 0.0166 NA Afipia genosp 9 0.1623 0.0125 0.0179 NA Streptococcus mutans 0.1613 0.0131 0.0187 −0.203 Prosthecobacter; Other 0.1592 0.0143 0.0204 NA Rheinheimera sp 09BSZB 9 0.1567 0.016 0.0226 −0.130 Xanthomonadaceae; Other 0.1567 0.016 0.0226 NA Sphingomonas yabuuchiae 0.1563 0.0163 0.0229 NA Paracoccus; Other 0.1517 0.0197 0.0275 NA Kocuria marina 0.1507 0.0205 0.0285 NA Flavobacterium; Other 0.1486 0.0224 0.0309 NA Peredibacter starrii 0.1486 0.0224 0.0309 NA Streptococcaceae; Other 0.1469 0.024 0.0329 NA Varibaculum cambriense 0.1452 0.0257 0.0350 NA Verrucomicrobium sp IRVE 0.1452 0.0257 0.0350 NA Lactobacillus sp KLDS 1 0716 0.1421 0.029 0.0393 −0.065 Negatively Faecalibacterium; Other −0.6171 0.0001 0.0002 0.819 correlated Clostridiales; Other −0.614 0.0001 0.0002 0.832 with Faecalibacterium prausnitzii −0.5937 0.0001 0.0002 0.860 community Prevotella sp DJF B112 −0.5859 0.0001 0.0002 −0.341 distance Bacteroides vulgatus −0.539 0.0001 0.0002 0.127 to healthy Ruminococcus callidus −0.5327 0.0001 0.0002 0.479 microbiota Ruminococcus; Other −0.5226 0.0001 0.0002 NA Ruminococcus sp 5 1 39BFAA −0.522 0.0001 0.0002 0.671 Eubacterium coprostanoligenes −0.5186 0.0001 0.0002 0.530 Parabacteroides; Other −0.5137 0.0001 0.0002 0.429 1760; Other −0.5099 0.0001 0.0002 #N/A Coprococcus; Other −0.5065 0.0001 0.0002 0.438 Clostridium disporicum −0.5027 0.0001 0.0002 0.699 Clostridium glycolicum −0.5001 0.0001 0.0002 0.633 Clostridium bartlettii −0.4979 0.0001 0.0002 0.341 Firmicutes; Other −0.4909 0.0001 0.0002 0.725 Eubacterium eligens −0.4878 0.0001 0.0002 0.696 Eubacterium sp cL 10 1 3 −0.486 0.0001 0.0002 0.223 Turicibacter sanguinis −0.4765 0.0001 0.0002 0.612 Ruminococcaceae; Other −0.4708 0.0001 0.0002 0.686 Eubacterium ramulus −0.4649 0.0001 0.0002 0.353 Roseburia; Other −0.4528 0.0001 0.0002 0.674 Lachnospiraceae; Other −0.4518 0.0001 0.0002 0.492 Clostridium clostridioforme −0.4498 0.0001 0.0002 0.334 Eubacterium rectale −0.442 0.0001 0.0002 0.457 Bacteroides galacturonicus −0.4347 0.0001 0.0002 0.547 Eubacterium biforme −0.4315 0.0001 0.0002 0.712 Bacteroides; Other −0.4309 0.0001 0.0002 0.549 Slackia isoflavoniconvertens −0.4305 0.0001 0.0002 0.465 Bifidobacterium; Other −0.4284 0.0001 0.0002 0.987 Blautia sp M25 −0.4267 0.0001 0.0002 NA Eubacterium hallii −0.4251 0.0001 0.0002 0.673 Ruminococcus sp ZS2 15 −0.4231 0.0001 0.0002 0.124 Eubacterium desmolans −0.4227 0.0001 0.0002 0.258 Dorea formicigenerans −0.4197 0.0001 0.0002 0.494 Prevotella copri −0.4098 0.0001 0.0002 0.776 Collinsella; Other −0.406 0.0001 0.0002 0.438 Prevotella sp DJF B116 −0.4032 0.0001 0.0002 0.633 Coprococcus eutactus −0.4031 0.0001 0.0002 0.526 Bacteroides ovatus −0.4028 0.0001 0.0002 0.460 Ruminococcus obeum −0.4012 0.0001 0.0002 0.301 Catenibacterium mitsuokai −0.3988 0.0001 0.0002 0.791 Subdoligranulum variabile −0.3979 0.0001 0.0002 0.498 Oscillibacter; Other −0.3949 0.0001 0.0002 0.304 Coriobacteriaceae; Other −0.3948 0.0001 0.0002 0.600 Bilophila wadsworthia −0.3942 0.0001 0.0002 0.312 Ruminococcus bromii −0.386 0.0001 0.0002 0.479 Clostridiaceae; Other −0.3807 0.0001 0.0002 0.641 Parabacteroides distasonis −0.3787 0.0001 0.0002 0.326 Collinsella aerofaciens −0.3754 0.0001 0.0002 0.584 Bacteroidales; Other −0.3752 0.0001 0.0002 0.700 Prevotella; Other −0.3565 0.0001 0.0002 −0.391 Clostridium; Other −0.3414 0.0001 0.0002 0.387 Dorea longicatena −0.334 0.0001 0.0002 0.358 Eubacterium; Other −0.3318 0.0001 0.0002 0.508 Clostridium hathewayi −0.3296 0.0001 0.0002 0.234 Alistipes shahii −0.3229 0.0001 0.0002 0.184 Mitsuokella multacida −0.3184 0.0001 0.0002 0.255 Clostridium sp SS2 1 −0.3175 0.0001 0.0002 0.122 Clostridium bolteae −0.3131 0.0001 0.0002 0.278 Oscillibacter sp G2 −0.3101 0.0001 0.0002 0.244 Ruminococcus flavefaciens −0.2997 0.0001 0.0002 0.133 Olsenella; Other −0.2933 0.0001 0.0002 0.092 Phascolarctobacterium faecium −0.2906 0.0001 0.0002 0.122 Alistipes sp NML05A004 −0.2905 0.0001 0.0002 0.092 Bacteroides uniformis −0.2895 0.0001 0.0002 0.087 Coprococcus comes −0.2874 0.0001 0.0002 0.378 Prevotella sp DJF LS16 −0.2814 0.0001 0.0002 0.092 Clostridium sp L2 50 −0.281 0.0001 0.0002 0.242 Bacteria; Other −0.269 0.0001 0.0002 0.672 Coprococcus catus −0.2667 0.0001 0.0002 0.199 Prevotella stercorea −0.2662 0.0001 0.0002 NA Bacteroides caccae −0.2596 0.0001 0.0002 0.143 Roseburia intestinalis −0.2593 0.0001 0.0002 0.562 Blautia; Other −0.2567 0.0001 0.0002 0.669 Desulfovibrio; Other −0.2443 0.0002 0.0004 0.274 Butyrivibrio crossotus −0.2353 0.0003 0.0006 0.273 Clostridium paraputrificum −0.2223 0.0006 0.0011 0.521 Parabacteroides merdae −0.2213 0.0006 0.0011 0.092 Ruminococcus sp DJF VR70k1 −0.2213 0.0006 0.0011 0.762 Clostridium perfringens −0.2211 0.0006 0.0011 0.286 Prevotella sp oral taxon 302 −0.2157 0.0009 0.0016 0.280 Sarcina ventriculi −0.2143 0.0009 0.0016 NA Clostridium nexile −0.2127 0.001 0.0018 0.233 Bacteroides sp CIP103040 −0.2075 0.0013 0.0022 0.112 Bacteroidetes; Other −0.2055 0.0015 0.0025 0.377 Prevotella sp RS2 −0.2055 0.0015 0.0025 0.214 Enterococcus cecorum −0.2033 0.0017 0.0029 0.116 Bacteroides stercoris −0.2003 0.002 0.0033 0.208 Ruminococcus gnavus −0.1991 0.0021 0.0035 0.430 Clostridium bifermentans −0.199 0.0021 0.0035 NA Phascolarctobacterium succinatutens −0.1973 0.0023 0.0038 0.383 Ruminococcus torques −0.1971 0.0023 0.0038 0.337 Alistipes finegoldii −0.1958 0.0025 0.0041 0.041 Megasphaera sp TrE9262 −0.1953 0.0026 0.0042 0.234 Olsenella sp A2 −0.1851 0.0043 0.0067 0.306 unclassified_Erysipelotrichaceae; Other −0.1807 0.0054 0.0083 0.156 Bacteroides fragilis −0.1727 0.0078 0.0116 0.445 Odoribacter splanchnicus −0.1717 0.0082 0.0122 0.129 Allisonella histaminiformans −0.1645 0.0114 0.0166 0.177 Eubacterium siraeum −0.1645 0.0114 0.0166 −0.216 Bacteroides plebeius −0.1638 0.0117 0.0169 0.600 Megamonas; Other −0.1532 0.0185 0.0259 0.192 Sutterella; Other −0.1414 0.0299 0.0404 −0.393 Megasphaera; Other −0.1362 0.0365 0.0491 0.092

TABLE 23 Composition of the artificial human gut microbial community Bacterium Phylum Strain Name Source Taxonomy ID* GenBank Accession Bacteroides caccae Bacteroidetes ATCC 43185 ATCC 411901 AAVM00000000.2 Bacteroides ovatus Bacteroidetes ATCC 8483 ATCC 411476 AAXF00000000.2 Bacteroides thetaiotaomicron Bacteroidetes VPI-5482 ATCC 226186 AE015928.1 Bacteroides uniformis Bacteroidetes ATCC 8492 ATCC 411479 AAYH00000000.2 Bacteroides vulgatus Bacteroidetes ATCC 8482 ATCC 435590 CP000139.1 Bacteroides cellulosilyticus WH2 Bacteroidetes N/A Reference 8 N/A ATFI00000000 Clostridium scindens Firmicutes ATCC 35704 ATCC 411468 ABFY00000000.2 Collinsella aerofaciens Actinobacteria ATCC 25986 ATCC 411903 AAVN00000000.2 Dorea longicatena Firmicutes DSM 13814 DSMZ 411462 AAXB00000000.2 Eubacterium rectale Firmicutes ATCC 33656 ATCC 515619 CP001107.1 Faecalibacterium prausnitzii Firmicutes M21/2 Reference 8 411485 ABED00000000.2 Parabacteroides distasonis Bacteroidetes ATCC 8503 ATCC 435591 CP000140.1 Ruminococcus obeum Firmicutes ATCC 29174 ATCC 411459 AAVO00000000.2 Ruminococcus torques Firmicutes ATCC 27756 ATCC 411460 AAVP00000000.2 *Based on NCBI Taxonomy database (www.ncbi.nlm.nih.gov/taxonomy/)

TABLE 24 EC relative abundance Spearman Adjusted p-value from correlation Fold change (mean total RPKM) ShotgunFunctionalizeR of relative D- D- D- D- abundance Ph1- Ph3- R- R- R- Ph1- Ph3- R- R- R- vs time Ph2 Ph4 Ph1 Ph2 Ph3 Ph2 Ph4 Ph1 Ph2 Ph3 P-value vs vs vs vs vs vs vs vs vs vs Spear- (FDR heal- heal- heal- heal- heal- heal- heal- heal- heal- heal- man cor- EC Annotation thy thy thy thy thy thy thy thy thy thy r rected) EC1.1.1.35 3-hydroxyacyl-CoA 0.6 0.3 0.7 0.8 1.1 0.0000 1.0000 0.0000 0.0000 0.0000 0.3626 0.0464 dehydrogenase EC1.2.1.3 Aldehyde dehydrogenase 0.7 0.9 0.8 0.8 0.9 0.0000 0.2606 0.0000 0.2333 0.0136 0.2328 0.2424 (NAD(+)) EC1.21.4.1 D-proline reductase 1.1 1.2 0.9 1.1 0.9 0.0000 0.0000 0.0000 0.0007 0.0317 −0.1883 0.3645 (dithiol) EC1.3.1.— NA 0.8 1.0 1.0 0.9 0.8 0.0000 0.0000 0.0000 0.0000 0.0184 0.0728 0.7097 EC1.4.1.13 Glutamate synthase 0.7 0.7 0.9 0.8 0.8 0.0000 0.0000 0.0000 0.0000 0.1225 0.3019 0.1083 (NADPH) EC1.4.1.3 Glutamate dehydrogenase 0.8 1.1 1.0 1.0 1.1 0.0002 0.0000 0.0000 0.0023 0.0484 0.2383 0.2341 (NAD(P)(+)) EC2.1.1.— NA 1881.2 290.3 35.5 13.3 1380.7 0.0000 0.0000 0.0000 0.0000 0.0000 −0.4938 0.0075 EC2.1.3.11 N-succinylornithine 1.3 1.8 2.1 1.2 0.8 0.0000 0.0000 0.0000 0.0014 0.4056 −0.1655 0.4360 carbamoyltransferase EC2.1.3.3 Ornithine 0.6 0.7 0.9 1.0 1.0 0.0022 0.0000 0.0000 0.0005 0.0422 0.5019 0.0075 carbamoyltransferase EC2.3.1.— NA 5.0 6.6 2.0 2.7 1.1 0.1143 0.0000 0.1184 0.6833 0.0000 −0.3261 0.0761 EC2.3.1.117 2,3,4,5-tetrahydropyridine- 1.8 1.8 1.5 1.2 0.7 0.0000 0.0000 0.0000 0.0000 0.6294 −0.5308 0.0047 2,6-dicarboxylate N- succinyltransferase EC2.3.1.35 Glutamate N- 0.6 0.9 1.0 1.3 0.9 0.0149 0.0000 0.0000 0.0000 0.1313 0.5616 0.0047 acetyltransferase EC2.3.3.10 Hydroxymethylglutaryl- 1.5 1.4 1.4 1.1 0.8 0.0000 0.0000 0.0000 0.0000 0.4787 −0.1355 0.4877 CoA synthase EC2.4.2.14 Amidophosphoribosyl- 0.5 0.8 0.9 1.2 1.0 0.0000 0.0000 0.0000 0.0000 0.4790 0.5388 0.0047 transferase EC2.5.1.49 O-acetylhomoserine 0.8 0.8 1.1 0.9 0.9 0.0000 0.0000 0.4459 0.0721 0.6926 0.4012 0.0278 aminocarboxypropyl- transferase EC2.6.1.2 Alanine transaminase 0.8 1.0 1.0 1.1 0.9 0.0000 0.0000 0.0000 0.0000 0.0008 0.3441 0.0608 EC2.6.1.66 Valine--pyruvate 2.3 2.2 1.2 1.8 0.8 0.0000 0.0000 0.0001 0.0000 0.0000 −0.3271 0.0761 transaminase EC2.6.1.83 LL-diaminopimelate 1.3 1.1 1.0 1.1 0.6 0.0000 0.0000 0.0002 0.0000 0.3916 −0.1562 0.4516 aminotransferase EC2.7.1.39 Homoserine kinase 0.6 0.6 0.9 0.8 0.9 0.0000 0.0000 0.0600 0.0006 0.0047 0.4455 0.0144 EC2.7.2.4 Aspartate kinase 1.2 2.1 1.9 1.4 1.0 0.0014 0.0000 0.0000 0.0000 0.7149 −0.1063 0.5965 EC3.4.—.— NA 0.7 0.9 1.1 1.1 1.0 0.0000 0.0000 0.0000 0.0000 0.3482 0.3816 0.0349 EC3.4.11.5 Prolyl aminopeptidase 0.6 0.8 1.3 1.2 0.8 0.0000 0.0000 0.0000 0.0421 1.0000 0.2676 0.1734 EC3.5.1.16 Acetylornithine deacetylase 1.4 1.8 1.6 0.9 0.8 0.0000 0.0000 0.0000 0.0065 0.7787 −0.5281 0.0047 EC3.5.1.53 N-carbamoylputrescine 4.2 25.9 10.1 0.7 1.0 0.0000 0.0000 0.0000 0.0003 1.0000 −0.1753 0.4062 amidase EC3.5.4.1 Cytosine deaminase 0.9 1.1 1.3 0.9 0.7 0.0000 0.0000 0.0000 0.0000 0.5662 −0.0406 0.8571 EC4.2.1.19 Imidazoleglycerol- 0.9 1.1 1.0 1.0 0.8 0.0000 0.0001 0.0000 0.0592 0.2813 −0.1084 0.5934 phosphate dehydratase EC4.2.1.20 Tryptophan synthase 0.6 1.1 1.3 0.6 0.7 0.0000 0.0001 0.0000 0.4848 0.0252 0.1446 0.4703 EC4.2.1.22 Cystathionine beta-synthase 0.8 1.1 1.2 1.3 1.0 0.0000 0.0000 0.0001 0.0006 0.0006 0.4040 0.0271 EC4.3.1.1 Aspartate ammonia-lyase 0.6 6.9 3.2 0.3 0.4 0.0000 0.0000 0.0000 0.3475 1.0000 −0.0492 0.8212 EC5.3.1.23 S-methyl-5-thioribose-1- 1.3 1.9 1.7 1.4 1.1 0.0000 0.0000 0.0039 0.0000 0.0021 0.0127 0.9363 phosphate isomerase EC5.4.99.5 Chorismate mutase 0.8 0.8 0.7 0.8 1.0 0.0000 0.0000 0.0000 0.0000 0.4790 0.1436 0.4703 EC6.3.1.2 Glutamate--ammonia ligase 1.2 1.5 1.0 1.2 0.8 0.0000 0.0000 0.0000 0.0000 1.0000 −0.1954 0.3426 EC6.3.5.4 Asparagine synthase 0.5 0.2 0.5 0.9 0.9 0.0000 0.0000 0.0116 0.0000 0.9039 0.5007 0.0075 (glutamine-hydrolyzing) EC6.3.5.5 Carbamoyl-phosphate 2.1 3.3 2.3 1.6 0.9 0.0000 0.0000 0.0000 0.0000 0.7708 −0.4774 0.0083 synthase (glutamine- hydrolyzing) EC1.1.1.303 NA 4.4 1.2 1.6 2.0 0.5 0.0000 0.0000 0.0001 0.0000 1.0000 −0.3922 0.0325 EC1.1.1.35 3-hydroxyacyl-CoA 0.6 0.3 0.7 0.8 1.1 0.0000 1.0000 0.0000 0.0000 0.0000 0.3626 0.0464 dehydrogenase EC1.1.1.37 Malate dehydrogenase 0.7 0.8 0.9 1.0 0.8 0.0509 0.0000 0.0000 0.0000 0.6533 0.2915 0.1246 EC1.2.1.10 Acetaldehyde 1.7 1.3 1.3 1.0 0.4 0.0000 0.0000 0.0000 0.0000 0.0135 −0.3376 0.0667 dehydrogenase (acetylating) EC1.2.1.2 Formate dehydrogenase 1.3 1.4 1.8 1.0 0.7 0.0000 0.2032 0.0000 0.0309 0.0000 −0.1387 0.4859 EC1.2.1.3 Aldehyde dehydrogenase 0.7 0.9 0.8 0.8 0.9 0.0000 0.2606 0.0000 0.2333 0.0136 0.2328 0.2424 (NAD(+)) EC1.2.4.1 Pyruvate dehydrogenase 0.4 0.2 0.4 0.6 0.8 0.0000 0.0000 0.0000 0.0000 0.0178 0.4347 0.0164 (acetyl-transferring) EC1.3.1.— NA 0.8 1.0 1.0 0.9 0.8 0.0000 0.0000 0.0000 0.0000 0.0184 0.0728 0.7097 EC2.3.1.— NA 5.0 6.6 2.0 2.7 1.1 0.1143 0.0000 0.1184 0.6833 0.0000 −0.3261 0.0761 EC2.3.3.10 Hydroxymethylglutaryl- 1.5 1.4 1.4 1.1 0.8 0.0000 0.0000 0.0000 0.0000 0.4787 −0.1355 0.4877 CoA synthase EC2.4.1.10 Levansucrase 4.5 9.2 2.3 1.8 0.4 0.0000 0.6783 1.0000 0.0000 1.0000 −0.3879 0.0345 EC2.4.1.25 4-alpha- 0.8 1.5 3.8 1.9 0.9 0.0000 0.0000 0.4014 0.9467 0.4638 0.1739 0.4062 glucanotransferase EC2.7.1.12 Gluconokinase 2.1 4.4 1.5 1.1 0.3 0.0000 0.2574 0.0421 0.0000 0.2079 −0.4349 0.0164 EC2.7.1.16 Ribulokinase 0.8 1.2 1.1 1.0 1.0 0.0000 0.0000 0.0000 0.0004 0.4638 0.0952 0.6347 EC2.7.1.45 2-dehydro-3- 0.8 0.4 1.5 0.9 0.8 0.0000 0.0000 0.0000 0.0441 0.0137 0.1231 0.5309 deoxygluconokinase EC2.7.7.12 UDP-glucose--hexose-1- 0.8 1.0 0.9 1.0 0.8 0.0003 0.0000 0.0000 0.0000 0.0005 0.0197 0.9363 phosphate uridylyltransferase EC2.7.7.13 Mannose-1-phosphate 0.6 0.3 0.6 1.0 1.0 0.0000 0.0000 0.0000 0.0009 0.6704 0.4360 0.0164 guanylyltransferase EC2.7.7.22 Mannose-1-phosphate 0.6 0.3 0.5 0.7 0.9 0.0000 0.0000 0.0000 0.0041 0.0415 0.2147 0.2925 guanylyltransferase (GDP) EC2.7.8.30 NA 1.0 0.4 0.5 0.6 0.4 0.0000 0.0392 0.0000 0.0000 0.1225 −0.1518 0.4648 EC2.7.9.1 Pyruvate, phosphate 0.9 1.3 1.5 1.1 0.9 0.0000 0.0000 0.0000 0.0000 0.0930 0.0342 0.8815 dikinase EC2.7.9.2 Pyruvate, water dikinase 0.8 1.2 1.1 1.2 0.9 0.8899 0.0000 0.0000 0.0004 0.0000 0.1449 0.4703 EC3.1.2.6 Hydroxyacylglutathione 1.0 1.0 0.9 1.1 1.0 0.0000 0.0000 0.0571 0.8598 0.3280 0.0875 0.6592 hydrolase EC3.1.3.— NA 1.3 1.6 1.7 1.7 0.9 0.0000 0.0000 0.0000 0.0000 0.8949 −0.0748 0.7097 EC3.2.1.1 Alpha-amylase 1.0 2.6 1.8 1.6 0.5 0.0562 0.0000 0.0000 1.0000 0.0032 −0.0129 0.9363 EC3.2.1.14 Chitinase 0.4 0.7 0.9 0.9 1.0 0.0000 0.0000 0.0000 0.0674 1.0000 0.4655 0.0102 EC3.2.1.20 Alpha-glucosidase 2.4 4.6 2.0 1.7 0.8 0.0000 0.0000 0.0000 0.0000 0.0000 −0.4073 0.0261 EC3.2.1.23 Beta-galactosidase 0.6 1.9 2.4 0.9 0.8 0.0000 0.0000 0.0000 0.0000 0.0000 0.0940 0.6347 EC3.2.1.26 Beta-fructofuranosidase 0.3 0.3 0.8 0.5 0.9 0.0000 0.0000 0.0000 0.0000 0.1481 0.4862 0.0075 EC3.2.1.52 Beta-N- 0.5 0.2 0.7 0.8 1.1 0.0295 0.0000 0.0000 0.0000 0.3981 0.3615 0.0464 acetylhexosaminidase EC3.2.1.85 6-phospho-beta- 0.3 0.2 0.3 0.8 1.0 0.0000 0.0000 0.0000 0.0000 0.0613 0.4896 0.0075 galactosidase EC3.2.1.86 6-phospho-beta- 0.9 1.1 0.9 1.0 0.8 0.0000 0.0000 0.0000 0.0000 0.0000 −0.1238 0.5309 glucosidase EC3.6.1.7 Acylphosphatase 0.7 1.0 1.2 1.0 0.9 0.0000 0.0000 0.2792 0.0005 0.2843 0.2195 0.2808 EC4.1.2.40 Tagatose-bisphosphate 0.5 0.6 0.9 0.8 1.2 0.0000 0.0000 0.0000 0.0000 0.0003 0.4712 0.0093 aldolase EC4.2.1.12 Phosphogluconate 0.5 0.7 0.7 1.0 1.0 0.0000 0.2685 0.0000 0.0448 0.0030 0.5441 0.0047 dehydratase EC4.2.1.7 Altronate dehydratase 1.0 1.1 1.2 1.1 0.9 0.0000 0.0000 0.1942 0.0393 0.7318 −0.0138 0.9363 EC5.1.2.3 3-hydroxybutyryl-CoA 0.6 0.5 0.8 0.9 0.8 0.0000 1.0000 0.0000 0.0000 0.0000 0.3819 0.0349 epimerase EC5.1.3.8 N-acylglucosamine 2- 1.0 0.7 0.8 1.0 1.0 0.0000 0.0000 0.0000 0.0000 1.0000 0.1501 0.4660 epimerase EC5.3.1.14 L-rhamnose isomerase 0.6 0.9 1.2 0.9 0.7 0.0000 0.0000 0.0001 0.0002 0.1062 0.1039 0.6008 EC5.3.1.25 L-fucose isomerase 1.0 1.2 1.0 1.0 1.2 0.3334 0.0000 0.0000 0.0026 0.1453 −0.0139 0.9363 EC5.3.1.26 Galactose-6-phosphate 0.7 1.0 1.0 0.9 0.8 0.0000 0.0000 0.0000 0.0002 0.0453 0.2018 0.3344 isomerase EC5.4.2.7 Phosphopentomutase 1.2 0.5 0.8 1.0 0.9 0.0000 0.0000 0.0000 0.0000 0.1024 −0.0206 0.9363 EC5.4.99.16 Maltose alpha-D- 0.4 0.6 1.0 1.1 0.7 0.0000 0.0000 0.0000 0.0000 0.7244 0.4121 0.0244 glucosyltransferase EC5.5.1.4 Inositol-3-phosphate 0.6 0.8 0.8 0.9 0.9 0.0000 0.0000 0.0000 0.0000 0.0659 0.4126 0.0244 synthase EC6.3.1.2 Glutamate--ammonia ligase 1.2 1.5 1.0 1.2 0.8 0.0000 0.0000 0.0000 0.0000 1.0000 −0.1954 0.3426 EC6.4.1.2 Acetyl-CoA carboxylase 0.7 0.8 0.9 0.9 0.9 0.0000 0.0000 0.0000 0.0000 0.1821 0.2656 0.1749 EC2.1.1.— NA 1881.2 290.3 35.5 13.3 1380.7 0.0000 0.0000 0.0000 0.0000 0.0000 −0.4938 0.0075 EC2.4.2.11 Nicotinate 0.7 0.9 1.3 1.2 1.0 0.0000 0.0000 0.0001 0.0000 0.0030 0.1976 0.3426 phosphoribosyltransferase EC2.6.1.62 Adenosylmethionine--8- 0.3 0.3 0.9 0.9 1.0 0.0000 0.0554 0.0000 0.1438 0.3047 0.5389 0.0047 amino-7-oxononanoate transaminase EC2.7.4.16 Thiamine-phosphate kinase 81.3 11.4 2.2 1.6 61.1 0.0000 0.0000 0.0000 0.0000 0.6166 −0.3854 0.0349 EC2.7.7.63 Lipoate--protein ligase 0.7 0.8 0.8 0.9 0.9 0.0000 0.0000 0.4459 0.0000 0.0007 0.5012 0.0075 EC3.4.—.— NA 0.7 0.9 1.1 1.1 1.0 0.0000 0.0000 0.0000 0.0000 0.3482 0.3816 0.0349 EC3.6.1.— NA 0.6 0.2 0.8 1.1 1.1 0.0000 0.0000 0.2258 0.0143 0.1579 0.5522 0.0047 EC4.1.2.25 Dihydroneopterin aldolase 0.7 1.0 1.0 1.0 0.9 0.0241 0.0000 0.0505 0.0000 1.0000 0.1750 0.4062 EC4.2.1.113 o-succinylbenzoate 0.6 0.5 0.9 0.8 0.7 0.0040 0.0000 0.0000 0.0039 0.4056 0.3061 0.1035 synthase EC4.99.1.1 Ferrochelatase 0.7 0.6 0.7 0.8 0.9 0.0000 0.0031 0.0087 0.0000 0.2843 0.3563 0.0499 EC6.1.1.17 Glutamate--tRNA ligase 0.6 0.8 0.9 0.7 0.8 0.0000 0.0000 0.0000 0.0000 0.2131 0.1590 0.4516 EC6.3.1.5 NAD(+) synthase 0.7 0.8 0.9 1.1 0.9 0.0000 0.0000 0.0000 0.0018 0.6387 0.4611 0.0103 EC6.3.2.1 Pantoate--beta-alanine 5.4 9.5 2.0 2.5 1.0 0.0000 0.0000 0.0000 0.0018 0.0096 −0.4800 0.0083 ligase EC6.3.5.1 NAD(+) synthase 1.2 2.1 1.3 1.3 0.8 0.0000 0.0000 0.0000 0.0000 0.1520 −0.2431 0.2283 (glutamine-hydrolyzing) EC6.1.1.1 Tyrosine--tRNA ligase 0.7 1.0 0.9 0.9 0.8 0.0000 0.0001 0.0000 0.2745 1.0000 0.2399 0.2337 EC6.1.1.16 Cysteine--tRNA ligase 0.6 0.8 0.7 0.7 0.8 0.0000 0.0004 0.0000 0.0243 0.3930 0.1439 0.4703 EC6.1.1.17 Glutamate--tRNA ligase 0.6 0.8 0.9 0.7 0.8 0.0000 0.0000 0.0000 0.0000 0.2131 0.1590 0.4516 EC6.1.1.18 Glutamine--tRNA ligase 0.7 1.9 2.9 1.1 1.2 0.0000 0.0000 0.0111 0.0000 0.3139 0.1562 0.4516 EC6.1.1.21 Histidine--tRNA ligase 0.6 0.8 0.9 0.9 0.9 0.0000 0.3446 0.0000 0.0000 0.0048 0.4881 0.0075 EC6.1.1.22 Asparagine--tRNA ligase 0.7 0.8 1.0 0.9 0.8 0.0000 0.0029 0.0901 0.0000 0.0703 0.2500 0.2122 EC6.1.1.24 Glutamate--tRNA(Gln) 0.7 0.9 0.9 1.0 0.9 0.0000 0.0000 0.0000 0.0000 0.0295 0.3712 0.0416 ligase EC6.1.1.4 Leucine--tRNA ligase 0.5 0.3 0.5 0.9 1.0 0.0000 0.0000 0.0000 0.0000 0.3546 0.4628 0.0103 EC6.3.5.6 Asparaginyl- 0.5 0.4 0.8 0.8 1.1 0.0000 0.0000 0.0000 0.0000 0.2595 0.4322 0.0167 tRNA synthase (glutamine-hydrolyzing)

TABLE 25 COPRO-seq results Days % of non-V. cholerae reads post Bacteroides initial cellulosilyticus Bacteroides Bacteroides Bacteroides Bacteroides Bacteroides Colinsella Group Mouse gavage WH2 caccae ovatus thetaiotaomicron uniformis vulgatus aerofaciens D1invasion 1 1 27.89% 12.66% 2.77% 22.48% 5.61% 8.54% 0.16% D1invasion 1 2 33.03% 10.73% 2.94% 26.56% 4.42% 11.19% 0.24% D1invasion 1 3 46.69% 8.35% 3.44% 18.14% 4.50% 9.98% 0.24% D1invasion 1 4 41.90% 8.35% 4.87% 13.66% 7.54% 11.10% 1.22% D1invasion 1 7 45.39% 5.49% 5.04% 10.62% 5.88% 14.61% 1.23% D1invasion 1 11 45.30% 6.55% 8.99% 7.34% 6.58% 16.49% 1.68% D1invasion 1 12 43.44% 8.04% 13.70% 8.03% 5.64% 11.74% 0.81% D1invasion 1 13 38.19% 9.50% 11.67% 10.10% 6.27% 11.66% 0.56% D1invasion 1 14 32.29% 8.30% 12.67% 9.36% 5.47% 10.79% 1.69% D1invasion 1 15 19.42% 10.78% 21.02% 12.05% 8.46% 13.95% 0.77% D1invasion 1 16 21.42% 7.74% 21.43% 12.10% 9.79% 14.25% 0.66% D1invasion 1 17 28.33% 6.83% 17.80% 10.61% 7.94% 12.45% 1.07% D1invasion 1 18 32.26% 6.60% 22.48% 9.98% 5.76% 13.68% 0.30% D1invasion 1 19 34.53% 5.81% 16.99% 10.02% 5.84% 13.62% 0.68% D1invasion 1 21 32.09% 6.03% 20.23% 9.46% 2.94% 16.94% 0.13% D1invasion 1 25 35.77% 5.84% 18.13% 10.70% 1.91% 16.44% 0.20% D1invasion 1 28 35.34% 5.05% 15.99% 12.26% 2.38% 15.46% 0.51% D1invasion 2 1 40.41% 17.66% 2.33% 16.80% 4.38% 7.82% 0.09% D1invasion 2 2 39.03% 9.80% 2.86% 21.18% 4.28% 6.99% 0.47% D1invasion 2 3 49.75% 6.38% 3.90% 18.76% 5.53% 8.43% 0.36% D1invasion 2 4 42.97% 5.83% 5.01% 12.92% 7.33% 12.06% 0.41% D1invasion 2 7 43.77% 7.91% 4.34% 7.78% 4.48% 16.42% 0.87% D1invasion 2 11 46.53% 9.17% 6.53% 8.49% 6.55% 15.83% 1.20% D1invasion 2 12 43.08% 10.27% 10.61% 8.24% 6.61% 13.78% 0.58% D1invasion 2 13 44.62% 9.72% 10.39% 8.86% 5.92% 10.83% 0.82% D1invasion 2 14 40.24% 9.53% 13.06% 9.61% 5.81% 10.89% 0.88% D1invasion 2 15 40.90% 8.39% 11.99% 8.55% 5.50% 10.54% 1.49% D1invasion 2 16 40.79% 8.72% 12.02% 9.37% 5.44% 11.79% 0.82% D1invasion 2 17 38.14% 8.02% 11.73% 10.92% 7.70% 10.91% 0.75% D1invasion 2 18 43.93% 8.91% 11.62% 9.09% 6.91% 9.92% 0.27% D1invasion 2 19 27.46% 9.84% 20.49% 11.90% 6.21% 14.29% 0.37% D1invasion 2 21 25.65% 7.83% 27.05% 11.25% 5.10% 12.21% 0.18% D1invasion 2 25 33.26% 5.58% 20.62% 12.84% 4.34% 11.23% 0.15% D1invasion 2 28 33.78% 4.91% 17.35% 13.27% 4.49% 11.28% 0.74% D1invasion 3 1 22.06% 11.94% 1.25% 38.62% 5.67% 5.45% 0.12% D1invasion 3 2 36.75% 9.52% 2.14% 30.45% 2.42% 9.23% 0.36% D1invasion 3 3 53.98% 8.22% 2.46% 13.64% 2.57% 10.71% 0.18% D1invasion 3 4 54.98% 6.94% 4.77% 9.13% 4.32% 10.09% 0.43% D1invasion 3 7 41.57% 5.26% 4.36% 7.96% 5.26% 22.19% 0.76% D1invasion 3 11 51.48% 8.23% 6.87% 8.19% 8.59% 9.08% 0.65% D1invasion 3 12 47.08% 7.71% 10.78% 7.50% 8.42% 9.88% 0.67% D1invasion 3 13 39.03% 8.24% 10.25% 9.05% 6.68% 12.50% 0.97% D1invasion 3 14 41.34% 7.86% 12.76% 8.34% 6.55% 11.44% 1.03% D1invasion 3 15 27.95% 8.13% 13.84% 10.11% 8.54% 15.22% 1.10% D1invasion 3 16 22.58% 6.60% 16.14% 11.35% 8.45% 20.72% 0.33% D1invasion 3 17 31.38% 4.87% 13.92% 9.80% 8.55% 19.26% 0.54% D1invasion 3 18 33.69% 5.26% 19.09% 9.56% 6.31% 15.35% 0.26% D1invasion 3 19 34.62% 4.41% 20.01% 9.08% 4.65% 15.55% 0.51% D1invasion 3 21 33.31% 4.36% 14.62% 9.21% 3.19% 24.37% 0.20% D1invasion 3 25 35.97% 5.42% 21.21% 10.43% 3.80% 14.37% 0.12% D1invasion 3 28 31.27% 4.32% 17.72% 11.64% 7.07% 16.81% 0.65% D1invasion 4 1 40.78% 13.29% 2.83% 11.03% 7.63% 9.86% 0.20% D1invasion 4 3 50.43% 8.51% 4.47% 11.59% 5.58% 8.91% 0.33% D1invasion 4 4 41.72% 9.22% 5.93% 14.56% 4.44% 11.49% 0.54% D1invasion 4 7 42.60% 4.79% 4.85% 9.85% 5.14% 19.10% 1.19% D1invasion 4 11 46.70% 6.36% 5.88% 7.62% 5.21% 19.27% 0.96% D1invasion 4 12 42.68% 9.20% 6.62% 7.91% 4.71% 17.96% 0.82% D1invasion 4 13 40.68% 8.38% 7.76% 8.71% 4.32% 17.70% 1.01% D1invasion 4 14 39.69% 8.49% 12.31% 8.38% 5.43% 12.26% 0.96% D1invasion 4 15 33.88% 11.47% 13.42% 11.89% 6.74% 13.27% 0.59% D1invasion 4 16 20.32% 9.34% 19.63% 12.49% 7.78% 16.73% 0.33% D1invasion 4 17 25.35% 7.58% 13.31% 11.25% 6.05% 22.12% 0.92% D1invasion 4 18 28.54% 6.71% 12.92% 10.25% 5.09% 22.76% 0.56% D1invasion 4 19 32.47% 5.99% 13.27% 9.70% 4.63% 17.77% 1.07% D1invasion 4 21 36.80% 6.39% 16.06% 9.59% 4.07% 16.10% 0.26% D1invasion 4 25 32.94% 5.32% 14.27% 9.38% 1.63% 19.03% 0.19% D1invasion 4 28 35.31% 4.82% 15.15% 11.37% 2.64% 16.14% 0.62% D1invasion 5 1 40.24% 15.55% 2.78% 19.56% 4.19% 7.33% 0.17% D1invasion 5 3 54.84% 6.67% 2.94% 17.70% 4.48% 7.43% 0.35% D1invasion 5 4 47.75% 5.82% 5.27% 10.37% 7.03% 11.37% 0.59% D1invasion 5 7 43.60% 6.42% 6.07% 10.45% 5.85% 13.78% 1.04% D1invasion 5 11 45.52% 9.75% 7.19% 8.69% 5.00% 11.72% 2.06% D1invasion 5 12 44.42% 9.52% 10.92% 10.34% 5.17% 10.88% 0.60% D1invasion 5 13 38.34% 10.18% 10.06% 10.11% 5.34% 13.84% 0.94% D1invasion 6 4 44.49% 5.47% 5.10% 9.55% 6.74% 14.83% 0.31% D1invasion 6 7 43.82% 6.48% 5.08% 12.20% 5.06% 14.68% 0.37% D1invasion 6 11 42.54% 6.52% 7.44% 9.52% 4.90% 16.32% 2.06% D1invasion 6 12 45.23% 7.75% 6.81% 9.35% 4.90% 16.21% 0.81% D1invasion 6 13 37.94% 6.86% 7.41% 9.51% 6.55% 15.19% 2.46% D1invasion 6 14 37.84% 7.77% 9.52% 11.64% 10.42% 14.86% 0.48% D1invasion 6 15 35.54% 7.85% 9.83% 9.48% 7.06% 14.64% 1.97% D1invasion 6 16 15.30% 8.32% 19.04% 13.69% 11.01% 21.80% 0.37% D1invasion 6 17 24.00% 6.26% 17.26% 11.93% 6.62% 19.60% 0.82% D1invasion 6 18 30.30% 5.56% 14.01% 10.11% 4.25% 20.63% 0.39% D1invasion 6 19 32.54% 6.36% 15.80% 10.66% 4.86% 19.71% 0.13% D1invasion 6 21 34.77% 6.88% 16.81% 10.25% 6.56% 17.09% 0.17% D1invasion 6 25 35.40% 5.89% 14.34% 9.38% 4.29% 19.76% 0.38% D1invasion 6 28 36.30% 5.47% 16.04% 10.41% 1.68% 18.48% 0.44% D14invasion 1 1 35.91% 26.51% 0.75% 10.36% 7.94% 7.63% 0.56% D14invasion 1 2 46.85% 15.62% 2.62% 17.83% 1.97% 6.38% 0.18% D14invasion 1 3 50.37% 10.69% 4.49% 10.97% 2.15% 11.80% 0.15% D14invasion 1 4 43.53% 8.05% 7.31% 12.49% 3.28% 11.19% 0.26% D14invasion 1 7 43.83% 7.28% 8.32% 9.87% 2.85% 17.29% 0.47% D14invasion 1 11 41.04% 8.25% 9.10% 10.86% 5.62% 13.64% 1.01% D14invasion 1 12 45.29% 9.92% 11.61% 9.49% 6.05% 13.09% 0.21% D14invasion 1 13 44.37% 8.18% 12.41% 8.71% 4.64% 14.29% 0.31% D14invasion 1 14 45.20% 7.21% 13.31% 9.16% 5.54% 13.33% 0.27% D14invasion 1 15 41.13% 7.49% 14.29% 8.60% 5.05% 15.83% 0.34% D14invasion 1 16 28.88% 10.95% 11.14% 15.91% 4.83% 14.59% 0.81% D14invasion 1 17 35.92% 6.53% 9.69% 16.28% 6.23% 12.98% 0.68% D14invasion 1 18 46.69% 4.65% 6.10% 10.58% 8.28% 12.14% 0.54% D14invasion 1 19 47.28% 3.69% 7.85% 5.43% 9.85% 14.17% 0.64% D14invasion 1 21 46.25% 2.52% 6.91% 7.53% 4.52% 21.60% 0.43% D14invasion 1 25 41.60% 4.50% 15.85% 10.64% 5.60% 13.57% 0.15% D14invasion 1 28 37.07% 4.70% 13.85% 9.86% 3.34% 21.00% 0.34% D14invasion 2 1 45.03% 12.28% 1.65% 14.64% 7.41% 8.82% 0.64% D14invasion 2 2 45.45% 16.10% 3.77% 17.66% 2.27% 6.49% 0.24% D14invasion 2 3 47.44% 11.72% 5.22% 12.22% 1.76% 10.67% 0.27% D14invasion 2 4 45.60% 8.41% 7.34% 12.57% 2.64% 12.87% 0.22% D14invasion 2 7 42.00% 7.95% 7.85% 9.11% 3.98% 17.07% 0.67% D14invasion 2 11 47.26% 7.79% 10.59% 8.69% 6.07% 11.21% 0.45% D14invasion 2 12 47.34% 3.90% 10.70% 9.64% 4.39% 13.46% 0.57% D14invasion 2 13 43.55% 4.43% 11.75% 9.92% 5.95% 12.54% 0.86% D14invasion 3 1 44.41% 14.52% 1.76% 14.48% 6.46% 11.12% 0.37% D14invasion 3 2 51.66% 15.83% 2.53% 14.07% 2.16% 7.50% 0.14% D14invasion 3 3 48.22% 12.97% 5.49% 13.48% 2.84% 8.91% 0.20% D14invasion 3 11 43.53% 9.84% 9.98% 10.25% 4.85% 10.91% 0.98% D14invasion 3 12 43.27% 10.75% 12.53% 9.79% 4.28% 12.73% 0.20% D14invasion 3 13 42.55% 8.79% 10.35% 8.27% 3.72% 20.50% 0.44% D14invasion 3 14 40.81% 8.53% 12.97% 7.74% 5.68% 16.94% 0.47% D14invasion 3 15 39.01% 7.47% 12.66% 8.29% 4.44% 22.35% 0.21% D14invasion 3 16 37.77% 6.02% 11.21% 7.88% 2.93% 25.83% 0.31% D14invasion 3 17 39.81% 6.37% 13.37% 8.84% 4.17% 18.52% 0.24% D14invasion 3 18 43.57% 4.40% 10.67% 9.12% 6.76% 16.60% 0.35% D14invasion 3 19 46.20% 3.24% 6.24% 7.63% 7.49% 16.19% 0.74% D14invasion 3 21 42.41% 1.94% 7.97% 8.90% 9.00% 17.77% 0.45% D14invasion 3 25 35.52% 3.96% 12.86% 10.60% 4.37% 23.09% 0.41% D14invasion 3 28 33.25% 5.90% 16.15% 11.26% 2.65% 21.89% 0.20% D14invasion 4 1 35.85% 12.52% 1.96% 17.65% 2.89% 4.78% 1.06% D14invasion 4 2 46.23% 14.12% 3.80% 17.60% 2.20% 6.45% 0.27% D14invasion 4 3 49.19% 11.71% 5.16% 14.42% 2.44% 8.23% 0.31% D14invasion 4 4 43.59% 8.83% 6.43% 13.67% 3.16% 13.70% 0.33% D14invasion 4 7 43.31% 8.71% 7.49% 11.04% 2.97% 15.53% 0.39% D14invasion 4 11 45.61% 10.14% 10.05% 10.26% 4.89% 11.03% 0.58% D14invasion 4 12 45.01% 9.37% 9.35% 9.67% 5.11% 12.09% 0.45% D14invasion 4 13 39.30% 8.58% 10.40% 9.52% 4.10% 14.97% 0.76% D14invasion 4 14 41.36% 5.28% 10.50% 8.69% 3.93% 21.59% 0.43% D14invasion 4 15 38.42% 4.75% 12.50% 9.50% 5.07% 19.32% 0.63% D14invasion 4 16 34.70% 6.91% 16.65% 9.65% 5.50% 16.89% 0.34% D14invasion 4 17 37.31% 3.76% 18.12% 9.21% 5.92% 15.18% 0.42% D14invasion 4 18 42.93% 3.13% 10.52% 9.68% 7.74% 16.09% 0.59% D14invasion 4 19 45.19% 3.27% 8.62% 8.13% 7.58% 15.10% 0.66% D14invasion 4 21 46.07% 3.72% 11.57% 8.61% 4.47% 16.55% 0.11% D14invasion 4 25 35.75% 3.92% 10.07% 9.60% 4.79% 20.84% 0.56% D14invasion 4 28 32.70% 5.37% 13.07% 9.94% 6.38% 18.43% 0.73% D14invasion 5 4 45.02% 10.35% 6.05% 13.62% 2.65% 10.70% 0.29% D14invasion 5 7 43.01% 8.15% 6.79% 10.38% 2.19% 18.09% 0.52% D14invasion 5 11 46.58% 9.38% 9.52% 8.96% 3.02% 15.06% 0.68% D14invasion 5 12 38.51% 9.64% 8.66% 7.65% 3.90% 23.56% 0.99% D14invasion 5 13 38.32% 7.32% 9.20% 8.47% 5.44% 20.57% 2.36% D14invasion 5 14 35.30% 7.52% 12.70% 10.81% 7.30% 17.25% 0.93% D14invasion 5 15 35.63% 7.14% 12.46% 8.74% 5.96% 21.53% 0.63% D14invasion 5 16 36.52% 5.28% 14.27% 7.87% 6.85% 21.60% 0.56% D14invasion 5 17 38.59% 3.14% 14.11% 7.45% 5.56% 20.68% 0.60% D14invasion 5 18 40.69% 2.78% 14.36% 9.01% 4.31% 19.08% 0.31% D14invasion 5 19 42.87% 2.63% 12.97% 8.54% 2.26% 17.91% 0.20% D14invasion 5 21 44.13% 2.05% 8.21% 7.26% 3.73% 21.21% 0.50% D14invasion 5 25 35.94% 3.37% 9.58% 6.89% 4.81% 24.06% 0.96% D14invasion 5 28 33.66% 4.45% 11.66% 7.14% 4.36% 25.19% 0.60% % of total Days % of non-V. cholerae reads reads post Faecali- Para- Rumino- Rumino- V. initial Clostridium Dorea Eubacterium bacterium bacteroides coccus coccus cholerae Group Mouse gavage scindens longicatena rectale prausnitzii distasonis obeum torques C6707 D1invasion 1 1 0.13% 1.68% 0.02% 0.00% 2.57% 4.08% 11.42% 46.27% D1invasion 1 2 0.54% 0.02% 0.19% 0.00% 5.96% 3.04% 1.14% 27.70% D1invasion 1 3 0.45% 0.00% 0.13% 0.00% 5.00% 2.85% 0.24% 21.88% D1invasion 1 4 0.74% 0.01% 0.15% 0.00% 5.09% 4.34% 1.04% 11.35% D1invasion 1 7 0.54% 0.00% 0.94% 0.00% 6.94% 2.41% 0.91% 1.77% D1invasion 1 11 0.49% 0.15% 1.35% 0.00% 1.73% 2.69% 0.66% 0.82% D1invasion 1 12 0.77% 0.52% 1.44% 0.00% 1.89% 2.77% 1.22% 0.36% D1invasion 1 13 0.74% 0.93% 1.63% 0.00% 3.15% 3.57% 2.02% 0.34% D1invasion 1 14 2.05% 1.67% 2.67% 0.00% 3.08% 6.52% 3.43% 0.50% D1invasion 1 15 0.86% 0.89% 2.56% 0.00% 4.71% 3.23% 1.30% 0.36% D1invasion 1 16 0.79% 0.48% 3.06% 0.00% 4.90% 2.17% 1.23% 0.21% D1invasion 1 17 0.73% 0.83% 2.40% 0.00% 6.04% 3.91% 1.06% 0.34% D1invasion 1 18 0.26% 0.28% 1.73% 0.00% 4.87% 1.22% 0.59% 0.15% D1invasion 1 19 0.58% 0.56% 2.81% 0.00% 5.45% 2.40% 0.71% 0.14% D1invasion 1 21 0.31% 0.36% 2.84% 0.00% 4.89% 2.11% 1.67% 0.03% D1invasion 1 25 0.28% 0.39% 1.44% 0.00% 5.82% 2.09% 1.00% 0.06% D1invasion 1 28 0.40% 0.40% 1.93% 0.00% 6.64% 2.14% 1.50% 0.07% D1invasion 2 1 0.04% 0.74% 0.01% 0.00% 2.89% 1.06% 5.77% 34.75% D1invasion 2 2 0.86% 0.05% 0.18% 0.00% 4.40% 8.48% 1.41% 15.44% D1invasion 2 3 0.50% 0.01% 0.16% 0.00% 4.16% 1.98% 0.08% 17.17% D1invasion 2 4 0.55% 0.00% 0.18% 0.00% 9.64% 2.41% 0.70% 10.07% D1invasion 2 7 0.55% 0.00% 0.80% 0.00% 8.87% 3.58% 0.63% 2.32% D1invasion 2 11 0.48% 0.09% 0.87% 0.00% 1.57% 1.88% 0.81% 0.67% D1invasion 2 12 0.45% 0.31% 1.03% 0.00% 1.97% 1.80% 1.26% 0.39% D1invasion 2 13 0.52% 0.37% 2.11% 0.00% 2.69% 2.07% 1.07% 0.27% D1invasion 2 14 0.67% 0.58% 1.63% 0.00% 3.02% 3.00% 1.09% 0.23% D1invasion 2 15 0.90% 0.92% 2.37% 0.00% 3.28% 3.44% 1.74% 0.16% D1invasion 2 16 0.44% 0.72% 1.90% 0.00% 3.78% 2.33% 1.87% 4.71% D1invasion 2 17 0.35% 0.54% 1.57% 0.00% 4.99% 1.46% 2.92% 1.16% D1invasion 2 18 0.32% 0.32% 1.30% 0.00% 4.00% 0.97% 2.45% 0.87% D1invasion 2 19 0.36% 0.51% 1.02% 0.00% 4.71% 1.57% 1.25% 0.38% D1invasion 2 21 0.41% 0.53% 1.73% 0.00% 4.07% 2.83% 1.14% 0.12% D1invasion 2 25 0.33% 0.40% 2.95% 0.00% 4.68% 1.93% 1.69% 0.04% D1invasion 2 28 0.61% 0.68% 1.99% 0.00% 5.75% 3.13% 2.03% 0.06% D1invasion 3 1 0.05% 1.13% 0.06% 0.00% 9.53% 1.53% 2.58% 48.83% D1invasion 3 2 0.45% 0.17% 0.09% 0.00% 3.97% 1.84% 2.61% 50.51% D1invasion 3 3 0.85% 0.00% 0.25% 0.00% 5.08% 1.72% 0.34% 58.83% D1invasion 3 4 0.60% 0.00% 0.31% 0.00% 5.79% 1.82% 0.82% 13.11% D1invasion 3 7 0.22% 0.00% 0.72% 0.00% 7.88% 3.53% 0.31% 1.52% D1invasion 3 11 0.20% 0.08% 0.92% 0.00% 2.74% 2.60% 0.39% 1.05% D1invasion 3 12 0.46% 0.33% 1.90% 0.00% 2.24% 2.30% 0.72% 0.82% D1invasion 3 13 1.08% 0.71% 2.10% 0.00% 3.25% 4.76% 1.38% 0.43% D1invasion 3 14 0.64% 0.39% 1.69% 0.00% 4.69% 2.27% 1.01% 0.70% D1invasion 3 15 1.03% 0.89% 2.59% 0.00% 5.19% 3.96% 1.43% 0.57% D1invasion 3 16 0.53% 0.46% 2.50% 0.00% 6.35% 2.84% 1.14% 0.13% D1invasion 3 17 0.50% 0.27% 0.88% 0.00% 7.55% 1.93% 0.54% 0.33% D1invasion 3 18 0.34% 0.17% 2.09% 0.00% 6.14% 0.87% 0.88% 0.13% D1invasion 3 19 0.54% 0.43% 1.64% 0.00% 5.15% 2.41% 0.99% 0.12% D1invasion 3 21 0.42% 0.25% 1.68% 0.00% 5.41% 2.08% 0.90% 0.10% D1invasion 3 25 0.22% 0.29% 1.25% 0.00% 5.22% 1.03% 0.68% 0.09% D1invasion 3 28 0.42% 0.23% 1.68% 0.00% 5.13% 2.48% 0.60% 0.04% D1invasion 4 1 0.06% 1.65% 0.01% 0.00% 5.03% 2.41% 5.22% 51.81% D1invasion 4 3 0.61% 0.00% 0.21% 0.00% 6.40% 2.77% 0.18% 29.25% D1invasion 4 4 0.48% 0.65% 0.35% 0.00% 6.64% 2.66% 1.32% 7.25% D1invasion 4 7 0.82% 0.00% 1.10% 0.00% 4.92% 4.86% 0.79% 0.88% D1invasion 4 11 0.29% 0.20% 1.15% 0.00% 2.88% 3.03% 0.45% 0.44% D1invasion 4 12 0.42% 0.26% 2.22% 0.00% 2.61% 3.79% 0.78% 0.47% D1invasion 4 13 0.70% 0.44% 2.84% 0.00% 3.29% 3.29% 0.88% 0.45% D1invasion 4 14 0.69% 0.75% 2.69% 0.00% 4.07% 3.09% 1.19% 0.61% D1invasion 4 15 0.26% 0.23% 1.96% 0.00% 4.76% 0.97% 0.56% 0.20% D1invasion 4 16 0.48% 0.51% 4.04% 0.00% 4.09% 2.13% 2.12% 0.16% D1invasion 4 17 0.59% 0.31% 3.26% 0.00% 6.15% 2.46% 0.65% 0.15% D1invasion 4 18 0.39% 0.32% 4.24% 0.00% 5.48% 2.12% 0.63% 0.08% D1invasion 4 19 0.76% 0.88% 2.66% 0.00% 4.26% 5.42% 1.11% 0.13% D1invasion 4 21 0.31% 0.31% 2.86% 0.00% 4.43% 1.88% 0.95% 0.06% D1invasion 4 25 0.31% 0.23% 7.09% 0.00% 6.50% 2.11% 1.00% 0.03% D1invasion 4 28 0.45% 0.35% 3.04% 0.00% 7.01% 2.36% 0.74% 0.05% D1invasion 5 1 0.12% 1.03% 0.05% 0.00% 3.85% 1.27% 3.87% 38.48% D1invasion 5 3 0.39% 0.00% 0.08% 0.00% 2.73% 2.30% 0.10% 13.45% D1invasion 5 4 0.57% 0.00% 0.13% 0.00% 8.49% 2.30% 0.29% 23.28% D1invasion 5 7 0.54% 0.00% 2.06% 0.00% 5.48% 2.97% 1.74% 0.84% D1invasion 5 11 0.76% 0.39% 2.05% 0.00% 2.28% 3.64% 0.94% 0.47% D1invasion 5 12 0.29% 0.34% 2.01% 0.00% 3.16% 1.42% 0.93% 0.31% D1invasion 5 13 0.70% 0.67% 2.02% 0.00% 3.35% 3.07% 1.39% 0.22% D1invasion 6 4 0.48% 0.00% 0.01% 0.00% 7.26% 3.29% 2.49% 2.49% D1invasion 6 7 0.31% 0.00% 0.38% 0.00% 6.00% 3.96% 1.66% 1.24% D1invasion 6 11 0.61% 0.00% 0.45% 0.00% 4.17% 3.89% 1.58% 0.52% D1invasion 6 12 0.39% 0.00% 0.22% 0.00% 3.85% 3.24% 1.24% 0.68% D1invasion 6 13 1.18% 0.00% 0.35% 0.00% 4.50% 6.26% 1.79% 0.48% D1invasion 6 14 0.16% 0.00% 0.05% 0.00% 6.23% 0.81% 0.21% 0.18% D1invasion 6 15 1.19% 0.00% 0.48% 0.00% 5.07% 4.86% 2.02% 1.00% D1invasion 6 16 0.45% 0.33% 0.42% 0.00% 5.66% 2.57% 1.04% 0.22% D1invasion 6 17 0.89% 0.74% 0.97% 0.00% 5.78% 3.52% 1.62% 0.08% D1invasion 6 18 0.66% 0.71% 0.57% 0.00% 6.44% 4.87% 1.50% 0.07% D1invasion 6 19 0.37% 0.38% 0.65% 0.00% 4.37% 2.43% 1.73% 0.05% D1invasion 6 21 0.27% 0.31% 0.52% 0.00% 3.99% 1.97% 0.41% 0.11% D1invasion 6 25 0.39% 0.18% 1.35% 0.00% 5.20% 2.30% 1.15% 0.05% D1invasion 6 28 0.30% 0.29% 1.36% 0.00% 6.95% 1.56% 0.72% 0.04% D14invasion 1 1 0.19% 2.29% 0.00% 0.07% 2.43% 1.32% 4.05% 2.11% D14invasion 1 2 0.10% 1.09% 0.31% 0.00% 3.93% 1.00% 2.12% 0.00% D14invasion 1 3 0.06% 1.01% 0.42% 0.00% 5.72% 1.06% 1.11% 0.01% D14invasion 1 4 0.14% 1.44% 3.65% 0.00% 4.56% 1.10% 3.01% 0.00% D14invasion 1 7 0.14% 0.17% 1.34% 0.00% 6.76% 1.13% 0.55% 0.00% D14invasion 1 11 0.46% 1.03% 1.18% 0.00% 1.89% 4.03% 1.90% 0.00% D14invasion 1 12 0.12% 0.32% 0.62% 0.00% 1.58% 1.09% 0.60% 0.00% D14invasion 1 13 0.27% 0.48% 1.26% 0.00% 2.41% 1.58% 1.09% 0.00% D14invasion 1 14 0.20% 0.34% 0.53% 0.00% 3.36% 1.11% 0.44% 0.00% D14invasion 1 15 0.26% 0.57% 0.65% 0.00% 2.91% 1.20% 1.68% 4.57% D14invasion 1 16 0.47% 0.53% 0.63% 0.00% 2.78% 3.13% 5.35% 6.29% D14invasion 1 17 0.74% 0.32% 0.34% 0.00% 4.52% 3.50% 2.29% 9.63% D14invasion 1 18 0.71% 0.22% 0.38% 0.00% 6.57% 2.00% 1.15% 5.27% D14invasion 1 19 0.81% 0.22% 0.32% 0.00% 6.28% 2.47% 0.99% 1.51% D14invasion 1 21 0.75% 0.23% 0.91% 0.00% 4.03% 3.61% 0.72% 0.21% D14invasion 1 25 0.26% 0.40% 0.50% 0.00% 5.20% 1.29% 0.43% 0.21% D14invasion 1 28 0.38% 0.39% 1.00% 0.00% 5.15% 1.57% 1.35% 0.05% D14invasion 2 1 0.07% 2.01% 0.00% 0.00% 1.39% 0.63% 5.41% 0.00% D14invasion 2 2 0.08% 0.94% 0.10% 0.00% 3.64% 0.66% 2.60% 0.02% D14invasion 2 3 0.24% 1.75% 0.38% 0.00% 4.22% 2.07% 2.05% 0.00% D14invasion 2 4 0.13% 1.34% 1.66% 0.00% 4.27% 0.82% 2.12% 0.00% D14invasion 2 7 0.32% 0.37% 1.23% 0.00% 6.23% 2.01% 1.22% 0.00% D14invasion 2 11 0.30% 1.01% 1.41% 0.00% 1.82% 1.85% 1.54% 0.00% D14invasion 2 12 0.20% 0.68% 2.44% 0.00% 2.10% 3.57% 1.01% 0.00% D14invasion 2 13 0.68% 1.24% 1.61% 0.00% 2.79% 3.21% 1.47% 0.00% D14invasion 3 1 0.05% 1.33% 0.00% 0.00% 0.99% 0.50% 4.01% 0.01% D14invasion 3 2 0.10% 0.68% 0.30% 0.00% 2.63% 0.69% 1.71% 0.00% D14invasion 3 3 0.06% 0.85% 0.55% 0.00% 4.27% 0.80% 1.37% 0.00% D14invasion 3 11 0.36% 0.66% 1.42% 0.00% 3.58% 2.09% 1.54% 0.00% D14invasion 3 12 0.25% 0.31% 1.80% 0.00% 1.92% 0.96% 1.23% 0.00% D14invasion 3 13 0.31% 0.43% 0.64% 0.00% 1.87% 1.56% 0.58% 0.00% D14invasion 3 14 0.26% 0.67% 0.68% 0.00% 2.68% 1.65% 0.92% 0.00% D14invasion 3 15 0.15% 0.24% 0.51% 0.00% 3.52% 0.75% 0.38% 0.20% D14invasion 3 16 0.27% 0.38% 0.21% 0.00% 4.60% 1.61% 0.97% 0.29% D14invasion 3 17 0.40% 0.57% 0.82% 0.00% 3.39% 2.01% 1.50% 0.22% D14invasion 3 18 0.50% 0.25% 0.60% 0.00% 4.66% 1.58% 0.94% 0.52% D14invasion 3 19 0.95% 0.11% 0.22% 0.00% 5.77% 4.55% 0.67% 1.64% D14invasion 3 21 0.74% 0.31% 1.29% 0.00% 4.51% 3.95% 0.77% 0.19% D14invasion 3 25 0.53% 0.28% 1.29% 0.00% 3.87% 2.19% 1.02% 0.03% D14invasion 3 28 0.25% 0.24% 0.96% 0.00% 5.10% 1.04% 1.10% 0.06% D14invasion 4 1 0.09% 8.35% 0.01% 0.00% 0.73% 4.11% 10.00% 0.01% D14invasion 4 2 0.10% 1.16% 0.94% 0.00% 2.93% 1.08% 3.14% 0.01% D14invasion 4 3 0.11% 0.93% 0.79% 0.00% 3.61% 1.20% 1.88% 0.00% D14invasion 4 4 0.12% 1.08% 0.72% 0.00% 5.40% 1.34% 1.63% 0.00% D14invasion 4 7 0.21% 0.20% 1.63% 0.00% 6.41% 0.79% 1.32% 0.00% D14invasion 4 11 0.22% 0.80% 1.24% 0.00% 2.37% 1.36% 1.46% 0.00% D14invasion 4 12 0.22% 0.59% 3.06% 0.00% 2.56% 1.18% 1.33% 0.00% D14invasion 4 13 0.52% 1.90% 1.97% 0.00% 2.79% 3.21% 1.98% 0.00% D14invasion 4 14 0.22% 0.48% 0.90% 0.00% 4.58% 1.12% 0.93% 0.00% D14invasion 4 15 0.41% 0.99% 0.92% 0.00% 4.12% 1.92% 1.47% 0.12% D14invasion 4 16 0.22% 0.67% 0.63% 0.00% 3.45% 1.38% 2.99% 0.36% D14invasion 4 17 0.42% 0.62% 1.86% 0.00% 3.56% 1.43% 2.19% 0.43% D14invasion 4 18 0.50% 0.11% 0.62% 0.00% 5.82% 1.29% 0.96% 1.10% D14invasion 4 19 0.49% 0.11% 0.40% 0.00% 7.90% 1.95% 0.59% 1.87% D14invasion 4 21 0.22% 0.16% 0.43% 0.00% 6.51% 0.99% 0.58% 0.27% D14invasion 4 25 0.61% 0.31% 1.70% 0.00% 5.47% 3.11% 3.26% 0.06% D14invasion 4 28 0.66% 0.97% 1.63% 0.00% 4.86% 2.64% 2.63% 0.05% D14invasion 5 4 0.09% 1.06% 2.67% 0.00% 3.63% 0.76% 3.11% 0.00% D14invasion 5 7 0.14% 0.20% 3.50% 0.00% 5.37% 0.69% 0.97% 0.00% D14invasion 5 11 0.17% 0.56% 2.20% 0.00% 1.74% 1.30% 0.83% 0.00% D14invasion 5 12 0.23% 0.45% 2.48% 0.00% 2.02% 1.37% 0.53% 0.00% D14invasion 5 13 0.36% 0.67% 2.07% 0.00% 3.02% 1.37% 0.83% 0.00% D14invasion 5 14 0.27% 0.45% 0.53% 0.00% 4.48% 2.01% 0.45% 0.00% D14invasion 5 15 0.27% 0.72% 1.21% 0.00% 3.08% 1.79% 0.83% 0.08% D14invasion 5 16 0.23% 0.31% 1.25% 0.00% 3.51% 0.86% 0.89% 0.34% D14invasion 5 17 0.40% 0.59% 2.04% 0.00% 4.09% 1.93% 0.80% 0.39% D14invasion 5 18 0.33% 0.19% 1.99% 0.00% 4.86% 1.32% 0.76% 0.10% D14invasion 5 19 0.61% 0.51% 3.21% 0.00% 3.52% 3.03% 1.74% 0.10% D14invasion 5 21 0.62% 0.16% 1.95% 0.00% 5.16% 3.49% 1.52% 0.09% D14invasion 5 25 0.79% 0.54% 2.36% 0.00% 6.10% 3.12% 1.48% 0.02% D14invasion 5 28 0.43% 0.30% 2.88% 0.00% 6.41% 1.56% 1.36% 0.05%

TABLE 26 Comparative analysis of in vivo V. cholerae and R. obeum transcriptional responses to co-colonization a. Transcriptional responses of known V. cholerae C6706 ΔluxS strain (MM883) virulence genes Virulence gene transcripts with mean RPKM >20 in at least one group of mice. P-values based on unpaired two-tailed Student's t-test. Mean Mean transcript transcript abundance abundance (RPKM) ± SEM Fold-difference (RPKM) ± SEM in mice co- (V. cholerae in mice mono- colonized with mono- colonized with V. cholerae colonized/co- Gene V. cholerae and R. obeum colonized) P-value Annotation VC0583 105 ± 5  18 ± 2 5.9 0.0000 hapR VC0826  67 ± 26 281 ± 63 0.2 0.0310 toxin co-regulated pilus biosynthesis protein P (tcpP) VC0828  41 ± 10 11 ± 5 3.7 0.0159 toxin co-regulated pilin (tcpA) VC0984 61 ± 5 20 ± 4 3.1 0.0001 cholera toxin transcriptional activator (toxR) VC1021 136 ± 24 19 ± 5 7.0 0.0004 LuxO represser protein (luxO) VC1049 198 ± 35 35 ± 5 5.7 0.0004 LysR family transcriptional regulator (aphB) VC1446 64 ± 7 16 ± 4 3.9 0.0002 toxin secretion transporter, putative VC1447 31 ± 6  6 ± 2 5.0 0.0010 RTX toxin transporter VC1448 26 ± 7  6 ± 1 4.1 0.0072 RTX toxin transporter VC1451 213 ± 14  63 ± 10 3.4 0.0000 RTX toxin RtxA (rtxA) VC2467 709 ± 88 294 ± 52 2.4 0.0024 RNA_polymerase sigma factor RpoE (aphA) VC2724 21 ± 4  5 ± 1 4.4 0.0010 cholera toxin secretion protein EpsM VCA0219  96 ± 24  34 ± 11 2.8 0.0289 haemolysin (hlyA) VCA1084 172 ± 16 40 ± 7 4.4 0.0000 toxin secretion ATP-binding protein VC0665 135 ± 10 30 ± 5 4.5 0.0000 sigma-54 dependent transcriptional regulator (vpsR) b. V. cholerae C6706 ΔluxS strain (MM883) transcriptional responses to co-colonization with R. obeum DESeq analysis of transcript differences d2 after gavage of V. cholerae into R. obeum mono-colonized mice vs d2 after mono-colonization of mice with V. cholerae P-value (Benjamini- Hochberg Gene Fold-difference P-value corrected) Annotation VCA1078 25.2 0.0000 0.0000 LuxR family transcriptional regulator (vqmA) VC0246 16.7 0.0000 0.0000 lipopolysaccharide/O-antigen transport protein VC0247 14.9 0.0000 0.0000 lipopolysaccharide/O-antigen transport protein VC0826 14.7 0.0000 0.0000 toxin co-regulated pilus biosynthesis protein P VC1113 14.7 0.0000 0.0007 8-amino-7-oxononanoate synthase VC1112 14.3 0.0002 0.0106 biotin synthase VC0245 12.7 0.0000 0.0000 rfbG protein VC0259 12.5 0.0000 0.0002 lipopolysaccharide biosynthesis protein RfbV VCA0628 11.0 0.0000 0.0025 SecA-related protein VCA0952 8.1 0.0001 0.0036 LuxR family transcriptional regulator VC0185 7.3 0.0000 0.0004 transposase, putative VC1111 6.4 0.0015 0.0459 adenosylmethionine--8-amino-7-oxononanoate transaminase VC0249 5.7 0.0000 0.0000 rfbL protein VC2385 5.5 0.0006 0.0225 RNA-directed DNA polymerase VC1143 5.4 0.0000 0.0033 ATP-dependent Clp protease adaptor protein ClpS VC1445 5.2 0.0001 0.0039 sensor histidine kinase/response regulator VC0365 5.0 0.0000 0.0002 bacterioferritin VCA0827 4.6 0.0000 0.0001 pterin-4-alpha-carbinolamine dehydratase VC1962 3.7 0.0009 0.0307 lipoprotein VC0242 3.7 0.0000 0.0004 phosphomannomutase VC1838 3.5 0.0005 0.0201 tolR membrane protein VC2399 3.3 0.0000 0.0002 cell division protein FtsQ VCA0947 3.3 0.0007 0.0270 spermidine n1-acetyltransferase VC1914 3.3 0.0012 0.0404 integration host factor subunit beta VC2587 3.3 0.0000 0.0001 30S ribosomal protein S17 VC0364 3.1 0.0010 0.0348 bacterioferritin-associated ferredoxin VC1595 3.1 0.0015 0.0453 galactokinase VCA0198 3.1 0.0000 0.0025 site-specific DNA-methyltransferase, putative VC1854 3.0 0.0014 0.0425 porin, putative VCA0130 3.0 0.0013 0.0404 D-ribose transporter subunit RbsB VC2078 2.8 0.0001 0.0058 ferrous iron transport protein A VC1144 2.8 0.0000 0.0012 ATP-dependent Clp protease ATP-binding subunit VC2679 2.8 0.0001 0.0073 50S ribosomal protein L31 VCA0867 2.8 0.0016 0.0485 outer membrane protein W VC0243 2.8 0.0002 0.0097 GDP-mannose 4,6-dehydratase VC0562 2.7 0.0000 0.0007 16S rRNA-processing protein RimM VC0608 2.7 0.0001 0.0044 iron(III) ABC transporter, periplasmic iron-compound-binding protein VC0947 2.6 0.0001 0.0047 D-alanyl-D-alanine carboxypeptidase VC1910 2.6 0.0004 0.0168 tRNA-(ms[2]io[6]A)-hydroxylase VC2249 2.5 0.0005 0.0206 (3R)-hydroxymyristoyl-ACP dehydratase VCA0566 2.5 0.0002 0.0106 transcriptional regulator VC0750 2.4 0.0001 0.0073 hesB family protein VC0241 2.4 0.0012 0.0404 mannose-1-phosphate guanylyltransferase VC2291 2.3 0.0003 0.0118 Na(+)-translocating NADH-quinone reductase subunit E VC2634 2.2 0.0012 0.0404 fimbrial assembly protein PilM, putative VC0046 2.2 0.0013 0.0420 peptide deformylase VC2561 0.4 0.0001 0.0045 uroporphyrin-III C-methyltransferase VC2607 0.4 0.0004 0.0165 glutathione-regulated potassium-efflux system ancillary protein KefG VC1409 0.4 0.0002 0.0098 multidrug resistance protein, putative VC0719 0.4 0.0012 0.0404 DNA-binding response regulator PhoB VC2182 0.4 0.0000 0.0009 4-diphosphocytidyl-2-C-methyl-D-erythritol kinase VCA0758 0.4 0.0003 0.0151 arginine transporter permease subunit ArtQ VC1391 0.4 0.0002 0.0108 multidrug transporter, putative VC2759 0.3 0.0002 0.0114 3-ketoacyl-CoA thiolase VCA0665 0.3 0.0012 0.0404 C4-dicarboxylate transporter DcuC VC0676 0.3 0.0012 0.0399 nptA protein VC0720 0.3 0.0001 0.0066 phosphate regulon sensor protein VC1823 0.2 0.0012 0.0399 PTS system, fructose-specific IIB component VC0721 0.2 0.0001 0.0057 phosphate ABC transporter, periplasmic phosphate-binding protein, putative VC0298 0.2 0.0001 0.0047 acetyl-CoA synthetase VC1337 0.2 0.0005 0.0209 methylcitrate synthase VC0299 0.2 0.0001 0.0047 DNA polymerase III subunit epsilon VC1335 0.1 0.0001 0.0058 GntR family transcriptional regulator c. R. obeum transcriptional responses to co-colonization with V. cholerae C6706 ΔluxS DESeq analysis of transcript differences d2 after gavage of V. cholerae into R. obeum mono-colonized mice vs d7 of mono-colonization with R. obeum (timepoint Immediately prior to gavage of V. cholerae) P-value Gene Fold-difference P-value (adjusted) Annotation RUMOBE00113 6.3 0.0000 0.0038 putative sugar transport system permease protein RUMOBE00114 4.4 0.0002 0.0428 putative sugar transport system permease protein RUMOBE00733 35.9 0.0000 0.0001 anaerobic sulfite reductase subunit C [EC: 1.8.1.—] RUMOBE03717 0.1 0.0000 0.0041 K07112 RUMOBE03830 0.2 0.0000 0.0031 glutamate synthase (ferredoxin) [EC: 1.4.7.1] RUMOBE03831 0.2 0.0000 0.0039 glutamate synthase (NADPH/NADH) small chain [EC: 1.4.1.13 1.4.1.14] RUMOBE03837 0.2 0.0001 0.0306 aspartyl-tRNA(Asn)/glutamyl-tRNA (Gln) amidotransferase subunit B [EC: 6.3.5.6 6.3.5.7]

TABLE 27 Distribution of homologs of AI-2 system genes in members of the artificial community Bacteroides cellulosilyticus Bacteroides Bacteroides Bacteroides Bacteroides Bacteroides Colinsella Gene WH2 caccae ovatus thetaiotaomicron uniformis vulgatus aerofaciens luxS 0 0 0 0 1 0 1 luxP 0 0 0 0 0 0 0 luxQ 75 31 58 48 31 28 2 luxO 2 1 3 1 1 1 1 luxU 0 0 0 0 0 0 0 luxR 12 8 15 8 9 10 5 lsrR 0 0 0 0 0 0 0 lsrA 0 0 0 0 0 0 0 lsrB 0 0 0 0 0 0 0 lsrC 0 0 0 0 0 0 0 lsrD 0 0 0 0 0 0 0 lsrK 0 1 0 0 0 0 0 lsrF 1 0 0 0 0 0 0 Clostridium Dorea Eubacterium Faecalibacterium Parabacteroides Ruminococcus Ruminococcus Gene scindens longicatena rectale prausnitzii distasonis obeum torques luxS 1 1 1 1 0 1 1 luxP 0 0 0 0 0 0 0 luxQ 0 0 1 5 26 13 1 luxO 0 1 0 0 1 0 0 luxU 0 0 0 0 0 0 0 luxR 1 1 2 1 5 2 0 lsrR 2 0 0 0 0 0 0 lsrA 1 0 0 0 0 3 0 lsrB 1 0 0 0 0 3 0 lsrC 0 0 0 0 0 2 0 lsrD 1 0 0 0 0 1 0 lsrK 6 0 0 0 0 2 0 lsrF 1 0 0 0 1 0 0 Based on best BLASTp hit to KEGG database (10−5 e-value cutoff)

TABLE 28 Transcriptional responses of the 14-member artificial community to V. cholerae Fecal meta-transcriptomes of mice in D1invasion vs D14invasion treatment groups (both groups sampled 4 days after initial gavage) Benjamini-Hochberg Fold difference (mean corrected P-value EC RPKM D14invasion)/mean (Shotgun assignment EC Annotation in KEGG RPKM D1invasion) FunctionalizeR) EC1.2.1.2 Formate dehydrogenase 0.18 6.11E−07 EC4.2.1.51 Prephenate dehydratase 0.32 1.62E−10 EC3.6.1.7 Acylphosphatase 0.34 2.04E−32 EC6.3.5.4 Asparagine synthase (glutamine-hydrolyzing) 0.35 2.01E−30 EC2.4.1.15 Alpha,alpha-trehalose-phosphate synthase (UDP-forming) 0.36 6.50E−36 EC3.2.1.10 Oligo-1,6-glucosidase 0.42 2.40E−34 EC3.4.19.11 Gamma-D-glutamyl-meso-diaminopimelate peptidase 0.43 1.71E−08 EC2.7.7.39 Glycerol-3-phosphate cytidylyltransferase 0.51 3.90E−14 EC1.18.1.1 Rubredoxin--NAD(+) reductase 0.51 8.06E−17 EC3.1.6.1 Arylsulfatase 0.52 4.67E−06 EC4.1.2.40 Tagatose-bisphosphate aldolase 0.53 2.52E−12 EC1.4.1.16 Diaminopimelate dehydrogenase 0.54 5.25E−59 EC2.7.1.144 Tagatose-6-phosphate kinase 0.54 6.56E−15 EC3.5.1.10 Formyltetrahydrofolate deformylase 0.55 1.71E−08 EC2.3.1.182 (R)-citramalate synthase 0.56 6.48E−06 EC1.7.2.2 Nitrite reductase (cytochrome; ammonia-forming) 0.56 7.12E−07 EC6.3.1.1 Aspartate--ammonia ligase 0.56 1.85E−14 EC2.1.1.37 DNA (cytosine-5-)-methyltransferase 0.57 1.83E−11 EC2.6.1.83 LL-diaminopimelate aminotransferase 0.58 1.09E−12 EC2.7.4.14 Cytidylate kinase 0.59 7.15E−59 EC3.5.1.24 Choloylglycine hydrolase 0.60 4.58E−12 EC1.4.3.5 Pyridoxal 5′-phosphate synthase 0.60 8.39E−06 EC5.1.3.— NA 0.60 2.99E−78 EC2.5.1.17 Cob(I)yrinic acid a,c-diamide adenosyltransferase 0.61 6.76E−19 EC5.1.1.7 Diaminopimelate epimerase 0.62 1.16E−25 EC2.1.1.63 Methylated-DNA--[protein]-cysteine S-methyltransferase 0.62 9.40E−06 EC1.4.1.13 Glutamate synthase (NADPH) 0.63 1.09E−27 EC1.4.1.14 Glutamate synthase (NADH) 0.63 1.09E−27 EC3.6.3.12 Potassium-transporting ATPase 0.63  7.27E−158 EC1.1.1.85 3-isopropylmalate dehydrogenase 0.64 7.80E−10 EC1.1.1.86 Ketol-acid reductoisomerase 0.65 5.89E−24 EC1.1.1.44 Phosphogluconate dehydrogenase (decarboxylating) 0.66 3.12E−34 EC3.4.23.36 Signal peptidase II 0.67 5.83E−14 EC1.11.1.15 Peroxiredoxin 0.67  1.47E−108 EC3.2.2.— NA 0.68 1.17E−21 EC1.2.1.21 Glycolaldehyde dehydrogenase 0.68 6.60E−06 EC1.2.1.22 Lactaldehyde dehydrogenase 0.68 6.60E−06 EC1.1.1.49 Glucose-6-phosphate dehydrogenase 0.68 2.90E−20 EC2.3.1.79 Maltose O-acetyltransferase 0.68 2.17E−06 EC2.5.1.47 Cysteine synthase 0.68 7.21E−15 EC1.6.99.3 NADH dehydrogenase 0.69 3.35E−09 EC1.11.1.9 Glutathione peroxidase 0.70 2.11E−07 EC3.4.23.— NA 0.71 9.75E−13 EC1.15.1.1 Superoxide dismutase 0.71 2.23E−79 EC4.2.1.11 Phosphopyruvate hydratase 0.72 5.14E−24 EC1.1.1.28 D-lactate dehydrogenase 0.74 3.38E−06 EC2.6.1.1 Aspartate transaminase 0.75 2.16E−08 EC1.5.1.2 Pyrroline-5-carboxylate reductase 0.76 1.83E−06 EC3.6.3.4 Copper-exporting ATPase 0.76 2.66E−07 EC2.7.7.3 Pantetheine-phosphate adenylyltransferase 0.76 3.68E−06 EC3.1.3.18 Phosphoglycolate phosphatase 0.77 1.36E−16 EC3.1.1.31 6-phosphogluconolactonase 0.77 6.57E−16 EC1.1.1.42 Isocitrate dehydrogenase (NADP(+)) 0.78 4.31E−08 EC1.6.5.3 NADH dehydrogenase (ubiquinone) 0.78 4.30E−18 EC6.5.1.2 DNA ligase (NAD(+)) 0.78 6.60E−06 EC2.7.1.4 Fructokinase 0.78 3.70E−09 EC3.4.21.— NA 0.78 1.85E−15 EC3.4.24.— NA 0.79 6.33E−26 EC4.2.1.3 Aconitate hydratase 0.79 2.18E−09 EC2.7.13.3 Histidine kinase 0.79 7.26E−18 EC2.7.8.— NA 0.80 6.11E−06 EC2.3.3.1 Citrate (Si)-synthase 0.81 5.24E−09 EC1.2.1.12 Glyceraldehyde-3-phosphate dehydrogenase (phosphorylating) 0.83 1.89E−39 EC2.4.2.10 Orotate phosphoribosyltransferase 0.85 1.92E−07 EC4.1.2.13 Fructose-bisphosphate aldolase 0.87 5.37E−17 EC4.2.1.52 Dihydrodipicolinate synthase 0.87 8.05E−06 EC3.6.3.14 H(+)-transporting two-sector ATPase 0.89 9.63E−36 EC4.1.1.49 Phosphoenolpyruvate carboxykinase (ATP) 0.92 1.33E−06 EC3.6.5.3 Protein-synthesizing GTPase 1.14 2.77E−33 EC3.5.1.28 N-acetylmuramoyl-L-alanine amidase 1.16 6.46E−08 EC5.3.1.6 Ribose-5-phosphate isomerase 1.18 4.62E−06 EC2.7.7.6 DNA-directed RNA polymerase 1.22 2.64E−26 EC3.2.1.23 Beta-galactosidase 1.22 1.16E−17 EC1.3.99.1 Succinate dehydrogenase 1.23 4.12E−14 EC3.2.1.21 Beta-glucosidase 1.25 1.40E−12 EC2.3.1.179 Beta-ketoacyl-acyl-carrier-protein synthase II 1.25 5.80E−11 EC3.2.1.51 Alpha-L-fucosidase 1.26 2.81E−10 EC3.6.1.1 Inorganic diphosphatase 1.26 7.71E−06 EC3.4.11.18 Methionyl aminopeptidase 1.27 5.04E−16 EC4.1.2.17 L-fuculose-phosphate aldolase 1.28 2.92E−07 EC3.2.1.52 Beta-N-acetylhexosaminidase 1.29 2.10E−22 EC1.6.5.— NA 1.30 2.81E−21 EC3.5.4.5 Cytidine deaminase 1.31 9.56E−08 EC3.4.11.4 Tripeptide aminopeptidase 1.31 2.78E−06 EC5.4.2.8 Phosphomannomutase 1.32 4.48E−14 EC6.1.1.15 Proline--tRNA ligase 1.32 3.43E−10 EC2.4.1.25 4-alpha-glucanotransferase 1.34 3.23E−09 EC1.21.4.2 Glycine reductase 1.34 2.61E−17 EC2.3.1.129 Acyl-[acyl-carrier-protein]--UDP-N-acetylglucosamine O- 1.36 4.80E−11 acyltransferase EC3.5.99.6 Glucosamine-6-phosphate deaminase 1.37 4.71E−43 EC2.7.1.69 Protein-N(pi)-phosphohistidine--sugar phosphotransferase 1.38 6.38E−90 EC2.4.1.1 Phosphorylase 1.39 2.87E−15 EC2.1.2.5 Glutamate formimidoyltransferase 1.39 8.70E−08 EC5.3.1.25 L-fucose isomerase 1.40 9.32E−46 EC3.1.1.53 Sialate O-acetylesterase 1.41 2.76E−07 EC2.1.2.10 Aminomethyltransferase 1.42 2.07E−15 EC2.7.2.7 Butyrate kinase 1.46 2.55E−07 EC3.4.13.9 Xaa-Pro dipeptidase 1.49 1.20E−12 EC1.4.4.2 Glycine dehydrogenase (decarboxylating) 1.50 1.21E−07 EC2.7.1.— NA 1.52 3.48E−06 EC5.3.1.4 L-arabinose isomerase 1.52 1.73E−40 EC2.7.2.2 Carbamate kinase 1.52 1.15E−11 EC2.7.1.15 Ribokinase 1.53 2.77E−10 EC4.1.1.15 Glutamate decarboxylase 1.55 6.66E−23 EC4.1.3.3 N-acetylneuraminate lyase 1.55 1.35E−78 EC2.7.1.5 Rhamnulokinase 1.59 2.55E−07 EC2.3.1.54 Formate C-acetyltransferase 1.61 5.51E−25 EC1.2.99.2 Carbon-monoxide dehydrogenase (acceptor) 1.61 1.06E−82 EC3.2.1.89 Arabinogalactan endo-1,4-beta-galactosidase 1.66 6.47E−23 EC5.1.3.8 N-acylglucosamine 2-epimerase 1.68  5.47E−114 EC3.2.1.55 Alpha-N-arabinofuranosidase 1.71 8.19E−26 EC3.4.11.9 Xaa-Pro aminopeptidase 1.76 1.11E−40 EC3.5.2.7 Imidazolonepropionase 1.77 3.84E−17 EC6.3.4.3 Formate--tetrahydrofolate ligase 1.78  2.53E−120 EC4.3.1.12 Ornithine cyclodeaminase 1.81 1.44E−10 EC2.7.1.30 Glycerol kinase 1.81 1.43E−16 EC3.5.4.2 Adenine deaminase 1.84 4.36E−10 EC1.1.1.14 L-iditol 2-dehydrogenase 1.89 3.73E−06 EC3.4.11.— NA 2.04 2.42E−12 EC1.97.1.9 Selenate reductase 2.18 3.68E−06 EC2.3.1.9 Acetyl-CoA C-acetyltransferase 2.27 3.97E−15 EC1.21.4.1 D-proline reductase (dithiol) 2.38 0 EC5.1.1.4 Proline racemase 2.49  6.89E−116 EC1.17.1.4 Xanthine dehydrogenase 2.55 1.03E−26 EC2.7.1.39 Homoserine kinase 2.73 1.20E−07 EC3.5.4.3 Guanine deaminase 2.79 7.29E−44 EC1.1.1.6 Glycerol dehydrogenase 2.83 3.27E−08 EC3.5.2.10 Creatininase 2.84 4.40E−17 EC1.1.1.157 3-hydroxybutyryl-CoA dehydrogenase 3.22 2.43E−22 EC4.1.2.— NA 5.05 7.58E−13 EC3.4.11.5 Prolyl aminopeptidase 5.18 2.20E−84 EC2.7.1.92 5-dehydro-2-deoxygluconokinase 7.26 1.14E−06 EC5.3.1.— NA 7.27 1.27E−06 EC2.8.3.1 Propionate CoA-transferase 7.80 3.77E−08 EC3.2.1.26 Beta-fructofuranosidase 10.71  1.93E−240 EC3.7.1.— NA 18.78 3.73E−10 EC2.7.10.1 Receptor protein-tyrosine kinase 19.32 1.88E−08

TABLE 29 PCR primers and bacterial strains Target gene Primer name Sequence SEQ ID NO: R. obeum luxS TA-ROlux-f CACCATGAAAAAAATTGCAAGTTTTACC 61 (RUMOBE02774) TA-ROlux-r TTATTCCGGATAAGTCAGACGTTC 62 V. cholerae luxS (VC0557) TA-VC0557-f CACCATGCCATTATTAGACAGTTTTACC 63 TA-VC0557-r TTAGTGAACCTTCAGCTCATTG 64 Antibiotics used for Strain maintenance of plasmid in Strain Background Plasmid description host bacterial strain Ptcp-lux C6706 pJZ376 Cm,  1 ug/mL PBAD-VCluxS DH5a VC0557 in pBAD202-TOPO Km, 50 ug/mL PBAD-ROluxS DH5a RUMOBE02774 in pBAD202-TOPO Km, 50 ug/mL PBAD-lacZ DH5a lacZ in pBAD202-TOPO Km, 50 ug/mL Cm, chloramphenicol, Km, kanamycin 

The invention claimed is:
 1. A method to determine the relative maturity of a subject's gut microbiota to identify and treat a subject in need of treatment, the method comprising: (a) detecting a relative abundance for each bacterial taxon in a group comprising (i) obtaining a fecal sample from a subject or providing a fecal sample obtained from a subject; (ii) isolating nucleic acids from the fecal sample; (iii) amplifying nucleic acids with primers directed at a variable region of a bacterial 16S rRNA gene; and (iv) detecting nucleic acids associated with bacterial taxa in the group by 16S rRNA sequencing or hybridization array; wherein the group comprises Faecalibacterium prausnitzii OTU ID 326792, Ruminococcus sp. 5 1 39BFAA OTU ID 189827, Lactobacillus ruminis OTU ID 470663, Dorea longicatena OTU ID 191687, Bifidobacterium longum OTU ID 72820, and Ruminococcus sp. 5 1 39BFAA OTU ID 194745; (b) determining a microbiota age for the subject's gut microbiota comprising applying the relative abundances of the bacterial taxa from step (a) to a regression model, wherein the model regresses, for a group of healthy subjects, relative abundances of the same bacterial taxa, as determined from a plurality of gut microbiota samples obtained over time for each healthy subject in the group, against the chronological age of each healthy subject in the group at the time the gut microbiota sample was obtained; (c) calculating the relative maturity of the subject's gut microbiota, wherein relative maturity=(microbiota age of the subject)−(microbiota age of a healthy subject of a similar chronological age); and (d) providing a treatment to the subject with a relative maturity that is a negative value to increase the relative maturity value.
 2. The method of claim 1, wherein the group comprises at least Faecalibacterium prausnitzii OTU ID 326792, Ruminococcus sp. 5 1 39BFAA OTU ID 189827, Lactobacillus ruminis OTU ID 470663, Dorea longicatena OTU ID 191687, Bifidobacterium longum OTU ID 72820, and Ruminococcus sp. 5 1 39BFAA OTU ID 194745 and at least one bacterial taxon from the group comprising of Lactobacillus mucosae OTU ID 15141, Bifidobacterium OTU ID 561483, Staphylococcus OTU ID 217996, Ruminococcus sp. 5 1 39BFAA OTU ID 364234, Catenibacterium mitsuokai OTU ID 287510, Dorea formicigenerans OTU ID 261912, Ruminococcus torques OTU ID 361809, Streptococcus thermophilus OTU ID 108747, Bifidobacterium sp. OTU ID 533785, Haemophilus parainfluenzae OTU ID 9514, Streptococcus sp. OTU ID 561636, Clostridium sp. OTU ID 312461, Clostridium ramosum OTU ID 470139, Clostridium sp. OTU ID 181834, Weissella cibaria OTU ID 148099, Bifidobacterium sp. OTU ID 469873, Clostridiales sp. OTU ID 185951, and Ruminococcaceae sp. OTU ID
 212619. 3. The method of claim 1, wherein the group in step (a) comprises at least Faecalibacterium prausnitzii OTU ID 326792, Ruminococcus sp. 5 1 39BFAA OTU ID 189827, Lactobacillus ruminis OTU ID 470663, Dorea longicatena OTU ID 191687, Bifidobacterium longum OTU ID 72820, Ruminococcus sp. 5 1 39BFAA OTU ID 194745, Lactobacillus mucosae OTU ID 15141, Bifidobacterium OTU ID 561483, Staphylococcus OTU ID 217996, Ruminococcus sp. 5 1 39BFAA OTU ID 364234, Catenibacterium mitsuokai OTU ID 287510, Dorea formicigenerans OTU ID 261912, Ruminococcus torques OTU ID 361809, Streptococcus thermophilus OTU ID 108747, Bifidobacterium sp. OTU ID 533785, Haemophilus parainfluenzae OTU ID 9514, Streptococcus sp. OTU ID 561636, Clostridium sp. OTU ID 312461, Clostridium ramosum OTU ID 470139, Clostridium sp. OTU ID 181834, Weissella cibaria OTU ID 148099, Bifidobacterium sp. OTU ID 469873, Clostridiales sp. OTU ID 185951, and Ruminococcaceae sp. OTU ID
 212619. 4. The method of claim 1, wherein the calculation for maturity is defined as a Microbiota-for-Age Z score (MAZ), wherein MAZ=((microbiota age of the subject)−(median microbiota age of a healthy subject of a similar chronological age))/(standard deviation of microbiota age of healthy subjects of the similar chronological age).
 5. The method of claim 1, wherein the age of the subject and the age of the healthy subject(s) are within about 1 month, about 2 months, or about 3 months.
 6. The method of claim 1, wherein the group of bacterial taxa in step (a) comprises at least 12 bacterial taxa from the group comprising of Bifidobacterium bifidum OTU ID 469852, Eubacterium desmolans OTU ID 170124, Faecalibacterium prausnitzii OTU ID 187010, Prevotella copri OTU ID 303304, Lactobacillus reuteri OTU ID 470527, Enterobacteriaceae sp. OTU ID 210269, Clostridium glycolicum OTU ID 182202, Ruminococcus obeum OTU ID 178122, Enterococcus faecalis OTU ID 540230, Prevotella copri OTU ID 309068, Bifidobacterium sp. OTU ID 24773, Enterococcus sp. OTU ID 554755, Escherichia coli OTU ID 305760, Prevotella sp. OTU ID 268604, Faecalibacterium prausnitzii OTU ID 188900, Eubacterium hallii OTU ID 174256, Bacteroides fragilis OTU ID 130663, Streptococcus sp. OTU ID 292424, Staphylococcus sp. OTU ID 269541, Ruminococcus sp. 5 1 39BFAA OTU ID 191900, Dialister sp. OTU ID 48207, Collinsella aerofaciens OTU ID 186029, Clostridium bartlettii OTU ID 325608, Lactobacillus sp. OTU ID 252321, Prevotella sp. OTU ID 195574, Ruminococcus sp. 5 1 39BFAA OTU ID 365047, Lactobacillus ruminis OTU ID 471308, Enterobacteriaceae sp. OTU ID 307981, Streptococcus sp. OTU ID 15382, Clostridium disporicum OTU ID 302844, Streptococcus parasanguinis OTU ID 528842, Bifidobacterium sp. OTU ID 131391, Megamonas sp. OTU ID 259261, Clostridium sp. OTU ID 248563, Megasphaera sp. OTU ID 162427, and Lactobacillus sp. OTU ID
 545371. 7. The method of claim 1, wherein the group of bacterial taxa in step (a) comprises at least Bifidobacterium bifidum OTU ID 469852, Eubacterium desmolans OTU ID 170124, Faecalibacterium prausnitzii OTU ID 187010, Prevotella copri OTU ID 303304, Lactobacillus reuteri OTU ID 470527, Enterobacteriaceae sp. OTU ID 210269, Clostridium glycolicum OTU ID 182202, Ruminococcus obeum OTU ID 178122, Enterococcus faecalis OTU ID 540230, Prevotella copri OTU ID 309068, Bifidobacterium sp. OTU ID 24773, Enterococcus sp. OTU ID 554755, Escherichia coli OTU ID 305760, Prevotella sp. OTU ID 268604, Faecalibacterium prausnitzii OTU ID 188900, Eubacterium hallii OTU ID 174256, Bacteroides fragilis OTU ID 130663, Streptococcus sp. OTU ID 292424, Staphylococcus sp. OTU ID 269541, Ruminococcus sp. 5 1 39BFAA OTU ID 191900, Dialister sp. OTU ID 48207, Collinsella aerofaciens OTU ID 186029, Clostridium bartlettii OTU ID 325608, Lactobacillus sp. OTU ID 252321, Prevotella sp. OTU ID 195574, Ruminococcus sp. 5 1 39BFAA OTU ID 365047, Lactobacillus ruminis OTU ID 471308, Enterobacteriaceae sp. OTU ID 307981, Streptococcus sp. OTU ID 15382, Clostridium disporicum OTU ID 302844, Streptococcus parasanguinis OTU ID 528842, Bifidobacterium sp. OTU ID 131391, Megamonas sp. OTU ID 259261, Clostridium sp. OTU ID 248563, Megasphaera sp. OTU ID 162427, and Lactobacillus sp. OTU ID
 545371. 8. The method of claim 1, wherein the treatment is for a gastrointestinal disease.
 9. The method of claim 8, wherein the gastrointestinal disease is malnutrition, an infection caused by an enteropathogen, ulcerative colitis, necrotizing enterocolitis, Crohn's disease, chronic diarrhea, or acute diarrhea.
 10. The method of claim 1, wherein the treatment is a probiotic.
 11. The method of claim 1, wherein the treatment is a therapeutic food.
 12. The method of claim 1, wherein the treatment is a probiotic and a therapeutic food. 